Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | M3492 | TX |
Y | 2080P0203X | Pediatric Critical Care Doctor | 85819 | GA |
NPI | 1134297815 |
---|---|
Provider Name | Heather K Viamonte |
First Address | Atlanta, GA 30341-5540 |
Second Address | Atlanta, GA 30322-1060 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 25/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003126221I | (05) | GA |
184422701 | (05) | TX |
184422702 | CIDC (01) | TX |