PEDIATRIC EPILEPSY AND CHILD (PEACH) NEUROLOGY


Address: 5935 Thoroughbred Way, Suwanee, GA 30024-1744
Phone: 8476917788

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).

Provider Overview

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

Taxonomy

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 Provider/Organization Names

Other Name Type Code
PEACH Neurology Doing Business As Name - Organization

Provider Secondary Practice Location

Address Telephone Number Fax Number
5935 Thoroughbred Way, Suwanee, GA 300241744 8476917788

Office Location

Street Address 5935 THOROUGHBRED WAY
City SUWANEE
State GA
Zip Code 30024-1744

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2084N0402X
Grouping Allopathic & Osteopathic Physicians
Classification Psychiatry & Neurology
Specialization Neurology with Special Qualifications in Child Neurology

Taxonomy Definition

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]

Providers in the same taxonomy and state

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
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Competitor

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City SUWANEE
Zip Code 30024

Improve Information

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Dataset Information

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.

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