Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Courtney Yung Widjaja, MD

Individual provider Pediatrics Physician · NPI 1356904379

Courtney Yung Widjaja, MD is a Pediatrics Physician in Lawrenceville, Georgia. Licensed in Georgia. Registered with an NPI since 2019.

Licensed in
GA
In the registry since
2019
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

595 Hurricane Shoals Rd NW Ste 300
Lawrenceville, GA 30046
Phone: (770) 995-0823
Fax: (770) 995-7018
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 92344 (GA)
Pediatrics Physician Taxonomy 208000000X · Licence 10825 (GA)

Record details

NPI number1356904379
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 16, 2019
Last updated in NPPESSeptember 23, 2022
Certification dateSeptember 23, 2022

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