Provider Demographics
NPI:1164832853
Name:SHEFFIE, JAMAR
Entity Type:Individual
Prefix:
First Name:JAMAR
Middle Name:
Last Name:SHEFFIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 PERIMETER CTR N
Mailing Address - Street 2:APT. 2345
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30346-2488
Mailing Address - Country:US
Mailing Address - Phone:225-235-5866
Mailing Address - Fax:770-981-2024
Practice Address - Street 1:5295 STONE MOUNTAIN HWY
Practice Address - Street 2:SUITE I
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-6416
Practice Address - Country:US
Practice Address - Phone:770-879-5646
Practice Address - Fax:770-981-2024
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPTA001824225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant