Provider Demographics
NPI:1518161033
Name:SANTORUM, JENNIFER ESTHER (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ESTHER
Last Name:SANTORUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4395 JOHNS CREEK PARKWAY, SUITE 150
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024
Mailing Address - Country:US
Mailing Address - Phone:770-814-1160
Mailing Address - Fax:770-814-1173
Practice Address - Street 1:4395 JOHNS CREEK PARKWAY, SUITE 150
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024
Practice Address - Country:US
Practice Address - Phone:770-814-1160
Practice Address - Fax:770-814-1173
Is Sole Proprietor?:No
Enumeration Date:2007-06-11
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29910208000000X
GA63950208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics