Provider Demographics
NPI:1457995672
Name:STANLEY, TEJAH ZHAMARE
Entity type:Individual
Prefix:MS
First Name:TEJAH
Middle Name:ZHAMARE
Last Name:STANLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3378 GREENBRIAR PKWY SW APT 9201
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-0620
Mailing Address - Country:US
Mailing Address - Phone:443-618-5308
Mailing Address - Fax:
Practice Address - Street 1:250 GEORGIA AVE SE STE 206
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-3000
Practice Address - Country:US
Practice Address - Phone:404-653-0374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor