PEDIATRIC EPILEPSY AND CHILD (PEACH) NEUROLOGY (NPI# 1811495989) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1811495989 |
Entity Type | Organization |
Organization Name | PEDIATRIC EPILEPSY AND CHILD (PEACH) NEUROLOGY |
Other Organization Name | PEACH NEUROLOGY |
Practice Address |
5935 Thoroughbred Way Suwanee GA 30024-1744 |
Practice Telephone | 8476917788 |
Mailing Telephone | 8476917788 |
Enumeration Date | 2018-01-24 |
Last Update Date | 2018-03-17 |
Authorized Official Name | DR. KOHILAVANI VELAYUDAM (DIRECTOR) |
Authorized Official Telephone | 8476917788 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2084N0600X |
Psychiatry & Neurology Specialization: Clinical Neurophysiology |
72584 | GA | Allopathic & Osteopathic Physicians |
Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
72584 | GA | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
PEACH Neurology | Doing Business As Name - Organization |
Address | Telephone Number | Fax Number |
---|---|---|
5935 Thoroughbred Way, Suwanee, GA 300241744 | 8476917788 |
Street Address |
5935 THOROUGHBRED WAY |
City | SUWANEE |
State | GA |
Zip Code | 30024-1744 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356996565 | Stephanie Arkin | Student in an Organized Health Care Education/Training Program | 25 Old Peachtree Rd Nw, Suwanee, GA 30024 | 2019-08-05 |
1164989638 | Laquitta Craft | Registered Nurse | 2855 Lawrenceville Suwanee Road Suite 330/340, Suwanee, GA 30024 | 2019-02-21 |
1467937235 | Greater Atlanta Monitoring, LLC | Electrodiagnostic Medicine | 3651 Peachtree Ste E. #331, Suwanee, GA 30024 | 2018-09-27 |
1760963482 | Esther Natacha Lafontant | Public Health or Welfare | 3205 Maple Terrace Drive, Suwanee, GA 30024 | 2018-08-22 |
1740778463 | Immaculate Healthcare Solutions, LLC | Home Health | 970 Peachtree Industrial Blvd Ste 8, Suwanee, GA 30024 | 2018-04-27 |
1053819235 | Sean Wonsuk Jang | Chiropractor | 3370 Lawrenceville Suwanee Rd Ste 118, Suwanee, GA 30024 | 2018-01-23 |
1932628468 | Silver Health Services, Inc. | Case Manager/Care Coordinator | 2640 Westbury Court, Swanee, GA 30024 | 2017-09-15 |
1285159095 | April L. Rivers | Nurse Practitioner | 4411 Suwanee Dam Rd Ste 110, Suwanee, GA 30024 | 2017-08-14 |
1144743840 | Nabil Elkareh | Pharmacist | 5049 Tarry Glen Drive., Suwanee, GA 30024 | 2017-07-25 |
1720508294 | Robert A Finkel Dds PC | Clinic/Center | 1325 Satellite Blvd Nw Ste 1304, Suwanee, GA 30024 | 2017-06-26 |
Find all providers in zip 30024 |
Taxonomy Code | 2084N0402X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology with Special Qualifications in Child Neurology |
A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376998096 | Coga Health | Psychiatry & Neurology | 139 Altama Connector, Pmb 316, Brunswick, GA 31525-1888 | 2016-05-02 |
1376961565 | Anna Wilson Bunker | Psychiatry & Neurology | 1086 1/2 Baxter St Ste A, Athens, GA 30606-6316 | 2014-04-03 |
1386819381 | Kohilavani Velayudam | Psychiatry & Neurology | 761 Walther Road, Suite 100, Lawrenceville, GA 30046 | 2008-04-30 |
1952575763 | Pierre Richard Fequiere | Psychiatry & Neurology | 705 17th St Ste 106, Columbus, GA 31901 | 2008-04-14 |
1609921881 | Asma Qureshi Fischer | Psychiatry & Neurology | 460 North Belair Rd, Evans, GA 30801 | 2007-01-25 |
1407910607 | South Georgia Neurological Associates, P.C. | Psychiatry & Neurology | 907 18th St E Ste 190, Tifton, GA 31794-3600 | 2006-12-21 |
1093884355 | Aijaz A Khalid | Psychiatry & Neurology | 170 Camden Hill Rd Ste A, Lawrenceville, GA 30045-7418 | 2006-11-08 |
1912978065 | Enrique J. Fernandez | Psychiatry & Neurology | 3226-c Hampton Avenue, Brunswick, GA 31520-4254 | 2006-01-27 |
1932768389 | Uloma Chinyere Ibezim | Psychiatry & Neurology | 1446 Harper St, Augusta, GA 30912-0012 | 2019-06-10 |
1841677010 | Michelle Tutmaher | Psychiatry & Neurology | 1400 Tullie Rd Ne, Atlanta, GA 30329-2309 | 2015-04-27 |
Find all providers with the same taxonomy |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.