Provider Demographics
NPI:1558395582
Name:ZRELOFF, JENNIFER JOHNSON (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOHNSON
Last Name:ZRELOFF
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:PATIENT CENTERED PRIMARY CARE
Mailing Address - Street 2:1525 CLIFTON RD NE 2ND FLOOR
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-4200
Mailing Address - Country:US
Mailing Address - Phone:404-778-2050
Mailing Address - Fax:404-727-2050
Practice Address - Street 1:PATIENT CENTERED PRIMARY CARE
Practice Address - Street 2:1525 CLIFTON RD NE 2ND FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-4200
Practice Address - Country:US
Practice Address - Phone:404-778-2050
Practice Address - Fax:404-727-2050
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA48840207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H21640Medicare UPIN