Provider Demographics
NPI:1649245374
Name:DIJAMCO, ARLENE L (MD, FAAP)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:L
Last Name:DIJAMCO
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:DIJAMCO
Other - Last Name:BOTELHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:900 OLD ROSWELL LAKES PKWY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-8663
Mailing Address - Country:US
Mailing Address - Phone:678-629-3988
Mailing Address - Fax:855-756-8564
Practice Address - Street 1:900 OLD ROSWELL LAKES PKWY
Practice Address - Street 2:SUITE 220
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-8663
Practice Address - Country:US
Practice Address - Phone:678-629-3988
Practice Address - Fax:855-756-8564
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA066592208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics