Provider Demographics
NPI:1437589702
Name:CEGIELSKI, JERRY PETER (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:PETER
Last Name:CEGIELSKI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:DR
Other - First Name:PETER
Other - Middle Name:
Other - Last Name:CEGIELSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:1600 CLIFTON RD NE
Mailing Address - Street 2:MAILSTOP E-10
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4018
Mailing Address - Country:US
Mailing Address - Phone:404-639-5329
Mailing Address - Fax:404-639-1566
Practice Address - Street 1:1600 CLIFTON RD NE
Practice Address - Street 2:MAILSTOP E-10
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-4018
Practice Address - Country:US
Practice Address - Phone:404-639-5329
Practice Address - Fax:404-639-1566
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2013-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA46942207RI0200X
TXJ7448207RI0200X
NC13768207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease