Southern Crescent Pediatrics PC

NPI #1972595999 in Stockbridge, Georgia

Provider Information

NPI Number: 1972595999
Entity Type: Organization
Organization Name: Southern Crescent Pediatrics PC
Primary Specialty: Pediatrics
Enumeration Date: Aug 16, 2005
Last Updated: Sep 30, 2011

Practice Location

Address: 150 MEDICAL BLVD
Address 2: STE B
City: Stockbridge
State: Georgia
ZIP Code: 30281-5053
Phone: (770) 389-9944

Authorized Official

Name: JUAN JOSE SHERWOOD, MD
Title: PRESIDENT
Phone: (770) 389-9944

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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