Basic Information
Provider Information
NPI: 1629152046
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEINMETZ
FirstName: JAMI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CPNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2660 SATELLITE BLVD
Address2:  
City: DULUTH
State: GA
PostalCode: 30096
CountryCode: US
TelephoneNumber: 4047858330
FaxNumber: 7704764553
Practice Location
Address1: 2660 SATELLITE BLVD
Address2:  
City: DULUTH
State: GA
PostalCode: 30096
CountryCode: US
TelephoneNumber: 4047858330
FaxNumber: 7704768390
Other Information
ProviderEnumerationDate: 10/24/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X124632GAY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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