Mountainside Pediatrics

NPI #1710267505 in Jasper, Georgia

Provider Information

NPI Number
1710267505
Entity Type
Organization
Organization Name
Mountainside Pediatrics
Primary Specialty
Clinic/Center - Primary Care
Enumeration Date
Aug 24, 2011
Last Updated
Aug 24, 2011

Practice Location

Address
12 SAMMY MCGHEE BLVD
Address 2
SUITE 102
City
Jasper
State
Georgia
ZIP Code
30143-7711
Phone
(706) 253-9898

Authorized Official

Name
DR. KHAWAJA RAZA MAHMOOD, M.D.
Title
SOLE PROPRIETOR
Phone
(706) 253-9898

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Primary CarePrimary Care

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