Provider Demographics
NPI:1467668210
Name:NAJJAR, DAVID JONATHAN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JONATHAN
Last Name:NAJJAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 491224
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30049-0021
Mailing Address - Country:US
Mailing Address - Phone:770-614-5454
Mailing Address - Fax:770-614-5119
Practice Address - Street 1:2850 HOG MOUNTAIN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-1012
Practice Address - Country:US
Practice Address - Phone:770-614-5454
Practice Address - Fax:770-614-5119
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA35961207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE67662Medicare UPIN
GA08BBQLXMedicare ID - Type Unspecified