MEDICARE: DR. JALAL ZUBERI 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	2080P0208X	Pediatric Infectious Diseases Physician	031690	GA
2	208000000X	Pediatrics Physician	031690	GA

General Provider Information

NPI Number	:	1952394298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JALAL ZUBERI MD

Provider Business Mailing Address
First Line	:	325 LESTER RD NW BLDG 100-A
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-4024
Country	:	US
Telephone Number	:	770-935-1515
Fax Number	:	770-935-1040

Provider Business Practice Location Address
First Line	:	325 LESTER RD NW STE C
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30044-4046
Country	:	US
Telephone Number	:	770-935-1515
Fax Number	:	770-935-1040

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

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	04/20/2022

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