Modupe D Mcintosh is a Pediatrics in Lilburn, Georgia. Modupe D Mcintosh practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for Modupe D Mcintosh is 1174522916. The last update date is 2014-12-30.
Modupe D Mcintosh's current location address is 635 Beaver Ruin Rd Nw, Lilburn, Georgia. You can contact this provider via phone number 6788072230 and fax number 7702675710. The mailing address for Modupe D Mcintosh is 635 Beaver Ruin Rd Nw, Lilburn, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Modupe D Mcintosh |
|---|---|
| Address | 635 Beaver Ruin Rd Nw, Lilburn, Georgia |
| Phone Number | 6788072230 |
| Fax Number | 7702675710 |
| Sole Proprietor | N |
| Credentials | CPNP |
NPI Number Detail
| NPI Number | 1174522916 |
|---|---|
| Provider Enumeration Date | 2005-07-14 |
| Last Updated Date | 2014-12-30 |
Provider Mailing Address Detail
| Address | 635 Beaver Ruin Rd Nw |
|---|---|
| City | Lilburn |
| State | Georgia (GA) |
| Post Code | 300473474 |
| Phone Number | 6788072230 |
| Fax Number | 7702675710 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 363Lp0200X |
| Licence No | RN092844 |
|
Definition: An advanced practice registered nurse expert in providing care to infants, children and adolescents. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 554500072E | GA | -- | |
| 554500072D | GA | -- | |
| 554500072A | GA | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Modupe D Mcintosh by the Centers for Medicare & Medicaid Services?
The Modupe D Mcintosh has been issued the NPI (National Provider Identifier) 1174522916. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Modupe D Mcintosh is physically located?
The Modupe D Mcintosh is situated at the following address: 635 Beaver Ruin Rd Nw, Lilburn, GA 300473474.
What is Modupe D Mcintosh's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Modupe D Mcintosh is Pediatrics, and the taxonomy code that classifies this field of practice is 363Lp0200X.
On what date was the 1174522916 assigned to Modupe D Mcintosh?
The Modupe D Mcintosh was issued its 1174522916 on 2005-07-14, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Modupe D Mcintosh, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Modupe D Mcintosh, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2014-12-30.