MAIN STREET INTERNAL MEDICINE & PEDIATRICS PC (NPI# 1619155306) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619155306 |
| Entity Type | Organization |
| Organization Name | MAIN STREET INTERNAL MEDICINE & PEDIATRICS PC |
| Other Organization Name | MAIN STREET PEDIATRICS PC |
| Practice Address |
401 S Main St Suite C5 Alpharetta GA 30009-7960 |
| Practice Telephone | 6782052437 |
| Practice Fax Number | 6782052439 |
| Mailing Telephone | 6782052437 |
| Mailing Fax Number | 6782052439 |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2009-01-22 |
| Authorized Official Name | DR. MARIBEL LABINDALAWA ANGKA SERVERA (PHYSICIAN) |
| Authorized Official Telephone | 6782052437 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 047657 | GA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 047388 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000884804C | 05 | |
| GA | 000860054D | 05 |
| Other Name | Type Code |
|---|---|
| Main Street Pediatrics PC | Doing Business As Name - Organization |
| Street Address |
401 S MAIN ST SUITE C5 |
| City | ALPHARETTA |
| State | GA |
| Zip Code | 30009-7960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470428 | Mindful Sport and Performance | Clinic/Center | 401 S Main St, Alpharetta, GA 30009-1974 | 2020-09-08 |
| 1457724874 | Eunice Momeh | Nurse Practitioner | 401 S Main St, Alpharetta, GA 30009-1974 | 2015-11-06 |
| 1225448178 | Neil D Patel | Internal Medicine | 401 S Main St, Suite A4, Alpharetta, GA 30009-1974 | 2014-04-30 |
| 1437576659 | Spectrum Internal Medicine, LLC | Clinic/Center | 401 S Main St, Suite B3, Alpharetta, GA 30009-1974 | 2014-03-26 |
| 1982941456 | Beverly Jean Tanner | Advanced Practice Midwife | 401 S Main St, Suite B-8, Alpharetta, GA 30009-1974 | 2013-01-03 |
| 1457601312 | Alpharetta Podiatry | Podiatrist | 401 S Main St, Unit A-1, Alpharetta, GA 30009-1974 | 2012-09-18 |
| 1689820748 | Omar Naoulo | Podiatrist | 401 S Main St, Unit A-1, Alpharetta, GA 30009-1974 | 2008-08-08 |
| 1841455094 | Ashish N Kakadia | Dentist | 401 S Main St, Suite B5, Alpharetta, GA 30009-1974 | 2008-07-26 |
| 1396911319 | Kathryn G Botelho | Advanced Practice Midwife | 401 S Main St, Suite B-8, Alpharetta, GA 30004-1974 | 2008-04-30 |
| 1295907863 | Alpharetta Highway Dental Group | Dentist | 401 S Main St, Alpharetta, GA 30004-1974 | 2008-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861017634 | Trinity Care Counseling | Community/Behavioral Health | 3475 Northwinds Parkway, 200, Alpharetta, GA 30009 | 2020-06-08 |
| 1437778354 | Therapeutic Alliance LLC | Social Worker | 2300 Lakeview Parkway, Suite 700, Alpharetta, GA 30009 | 2020-04-10 |
| 1457901209 | Carehere LLC | Family Medicine | Carehere Clinic- Jackson Healthcare, 2655 Northwinds Pkwy, Alpharetta, GA 30009 | 2019-09-13 |
| 1952888927 | Total Access Pediatrics LLC | Pediatrics | 401 S Main St Ste A1, Alpharetta, GA 30009 | 2018-07-23 |
| 1356836878 | Hcenti, LLC | Audiologist-Hearing Aid Fitter | 2365 Old Milton Parkway, Alpharetta, GA 30009 | 2018-06-27 |
| 1093203341 | Samantha Elizabeth Heuwagen | Marriage & Family Therapist | 286 S Main St Ste 100, Alpharetta, GA 30009 | 2018-04-23 |
| 1275035578 | Personal Concierge Md, LLC | Internal Medicine | 10105 Westside Parkway, Suite 110, Alpharetta, GA 30009 | 2018-03-02 |
| 1124474929 | Allyne Anesthesia PC | Anesthesiology | 11675 Rainwater Drive, Suite 250, Alpharetta, GA 30009 | 2016-05-11 |
| 1932579885 | Patricia Aycock Jones Garrett | Nurse Practitioner | 1031a Cambridge Square, Alpharetta, GA 30009 | 2015-10-05 |
| 1558770123 | Terry A Williams | Physician Assistant | 2400 Old Milton Parkway, #1433, Alpharetta, GA 30009 | 2014-08-07 |
| Find all providers in zip 30009 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952888927 | Total Access Pediatrics LLC | Pediatrics | 401 S Main St Ste A1, Alpharetta, GA 30009 | 2018-07-23 |
| 1467849935 | Rosalie Vayman | Pediatrics | 3005 Royal Blvd S Ste 110, Alpharetta, GA 30022-1407 | 2015-04-22 |
| 1043506264 | Gargi Anil Shikhare | Pediatrics | 12324 Deer Trail, Alpharetta, GA 30004 | 2011-06-27 |
| 1972667442 | Amanda H Hwang | Pediatrics | 6340 Deerwoods Trl, Alpharetta, GA 30005 | 2006-12-20 |
| 1093888588 | Maia Alees Walton | Pediatrics | 3070 Windward Plz, Suite 333f, Alpharetta, GA 30005-8771 | 2006-11-15 |
| 1972693299 | Madhuri Viswanadham | Pediatrics | 11125 Jones Bridge Rd Ste 100, Alpharetta, GA 30022-0001 | 2006-10-15 |
| 1568560514 | Jeffrey Abrams | Pediatrics | 510 Clarinbridge Way, Alpharetta, GA 30022-6418 | 2006-09-20 |
| 1184631368 | Stephanie Beth Muller-dale | Pediatrics | 11975 Morris Road, Ssite 210, Alpharetta, GA 30005 | 2006-08-01 |
| 1861412496 | Howard W. Silverman | Pediatrics | 11525 Haynes Bridge Rd Ste 200, Alpharetta, GA 30009-4822 | 2006-07-19 |
| 1376570192 | Douglas S Josephson | Pediatrics | 12385 Crabapple Rd, Alpharetta, GA 30004-6357 | 2006-06-27 |
| Find all providers in ALPHARETTA | ||||
| City | ALPHARETTA |
| Zip Code | 30009 |
Please comment or provide details below to improve the information on MAIN STREET INTERNAL MEDICINE & PEDIATRICS PC.
| 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.