MEDICARE: JENNIFER EILEEN NATHAN-FORERO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	MD038111	DC
2	2085R0202X	Diagnostic Radiology Physician	90785	GA

General Provider Information

NPI Number	:	1366692717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER EILEEN NATHAN-FORERO MD

Provider Business Mailing Address
First Line	:	1364 CLIFTON RD NE STE 500
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1059
Country	:	US
Telephone Number	:	952-595-1301
Fax Number	:	612-294-4903

Provider Business Practice Location Address
First Line	:	777 7TH ST NW
Second Line	:	APT 722
City	:	WASHINGTON
State	:	DC
Zip	:	20001-5707
Country	:	US
Telephone Number	:	952-595-1100
Fax Number	:	612-294-4903

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2008
Last Update Date	:	06/27/2024

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