Provider Demographics
NPI:1700163946
Name:DR. MARIA JAUHAR GROUP, INC.
Entity Type:Organization
Organization Name:DR. MARIA JAUHAR GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAUHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-933-9111
Mailing Address - Street 1:100 BLUE FIN CIR
Mailing Address - Street 2:SUITE 7
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2462
Mailing Address - Country:US
Mailing Address - Phone:912-897-6832
Mailing Address - Fax:912-897-7151
Practice Address - Street 1:100 BLUE FIN CIR
Practice Address - Street 2:SUITE 7
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-2462
Practice Address - Country:US
Practice Address - Phone:912-897-6832
Practice Address - Fax:912-897-7151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA062898207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPENDINGMedicaid
GAPENDINGMedicare PIN