Lakeside Pediatrics, LLC

NPI #1326317520 in Cumming, Georgia

Provider Information

NPI Number: 1326317520
Entity Type: Organization
Organization Name: Lakeside Pediatrics, LLC
Primary Specialty: Pediatrics
Enumeration Date: Dec 19, 2011
Last Updated: Dec 19, 2011

Practice Location

Address: 204 CANTON RD
City: Cumming
State: Georgia
ZIP Code: 30040-2304
Phone: (770) 886-5437

Authorized Official

Name: BOB B BAGHERI, M.D.
Title: PRESIDENT
Phone: (770) 886-5437

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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