NPI 1548301914

Grace Pediatrics, LLC

Organisation Pediatrics Physician Wetumpka, AL

Practice location

Address: 74186 Tallassee Hwy Suite B, Wetumpka, AL 36092-5643
Phone: (334) 567-0346
Fax: (334) 567-0855
Mailing address: 138 Bryan St, Prattville, AL 36066-5348

Authorised official

Name: Michelle P Medina
Title: Single Member
Phone: (334) 358-5145

Registered specialties

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 22736 (AL)

Other Pediatrics providers in Alabama →

Registry record

NPI: 1548301914
Entity type: Organization
NPI issued: 9 Feb 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.