Provider Demographics
NPI:1396125688
Name:ABDUL-MAJID, JAMAL
Entity type:Individual
Prefix:
First Name:JAMAL
Middle Name:
Last Name:ABDUL-MAJID
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KENSINGTON CIR
Mailing Address - Street 2:APT. 11304
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6992
Mailing Address - Country:US
Mailing Address - Phone:678-524-5254
Mailing Address - Fax:
Practice Address - Street 1:100 KENSINGTON CIR
Practice Address - Street 2:APT. 11304
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6992
Practice Address - Country:US
Practice Address - Phone:678-524-5254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030024887172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker