Healthcare Provider Details

I. General information

NPI: 1437562980
Provider Name (Legal Business Name): JAYDEVSINH DOLIA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 10/28/2023
Certification Date: 10/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 JESSE HILL JR DR SE
ATLANTA GA
30303-3031
US

IV. Provider business mailing address

PO BOX 603898
CHARLOTTE NC
28260-3898
US

V. Phone/Fax

Practice location:
  • Phone: 601-462-9584
  • Fax:
Mailing address:
  • Phone: 843-792-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number86337
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberTPME5866
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number90921
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: