Healthcare Provider Details

I. General information

NPI: 1730160342
Provider Name (Legal Business Name): CINDY L JUSTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 OLD MILTON PKWY, BLDG A SUITE 330
ALPHARETTA GA
30005
US

IV. Provider business mailing address

4912 VERMACK RD
DUNWOODY GA
30338-5044
US

V. Phone/Fax

Practice location:
  • Phone: 770-751-6111
  • Fax:
Mailing address:
  • Phone: 770-934-9672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number033368
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: