United Pediatrics PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

045783 Issued in GA

Legal business name

UNITED PEDIATRICS PC

Practice address

4775 Jimmy Carter Blvd
Suite 102
Norcross, GA 30093-3760

Phone

(770) 717-0033

Fax

(770) 717-0028

NPI assigned

Dec 15, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tayaba Fatema, MD

Title

Owner

Phone

(770) 717-0033

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1003119934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4775 JIMMY CARTER BLVD",
            "address_2": "SUITE 102",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933760",
            "telephone_number": "770-717-0033",
            "fax_number": "770-717-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4775 JIMMY CARTER BLVD",
            "address_2": "SUITE 102",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300933760",
            "telephone_number": "770-717-0033",
            "fax_number": "770-717-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "FATEMA",
        "authorized_official_first_name": "TAYABA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-717-0033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "045783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Norcross, GA
• Providers in Norcross, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.