Provider Demographics
NPI:1952394298
Name:ZUBERI, JALAL (MD)
Entity Type:Individual
Prefix:DR
First Name:JALAL
Middle Name:
Last Name:ZUBERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 LESTER RD NW BLDG 100-A
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-4024
Mailing Address - Country:US
Mailing Address - Phone:770-935-1515
Mailing Address - Fax:770-935-1040
Practice Address - Street 1:325 LESTER RD NW STE C
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-4046
Practice Address - Country:US
Practice Address - Phone:770-935-1515
Practice Address - Fax:770-935-1040
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0316902080P0208X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0004669142Medicaid
GA0004669142Medicaid
F03473Medicare UPIN