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NPI Code Detail

MEDICARE: JENNIFER EILEEN NATHAN-FORERO MD

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
12085R0202XDiagnostic Radiology PhysicianMD038111DC
22085R0202XDiagnostic Radiology Physician90785GA

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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Directions to “ JENNIFER EILEEN NATHAN-FORERO MD” Practice Location

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