MEDICARE: DR. JENNIE HONLOI LAW M.D

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	207R00000X	Internal Medicine Physician	002869	GA
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	104956	MN
3	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	53389	MN
4	208M00000X	Hospitalist Physician	70313	GA
5	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	70313	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00940150	OTHER	MN	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386821049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIE HONLOI LAW M.D

Provider Business Mailing Address
First Line	:	5695 RILEY TER
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-4361
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3400 OLD MILTON PKWY STE A130
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30005-4417
Country	:	US
Telephone Number	:	770-664-8898
Fax Number	:	770-772-4377

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

Provider Enumeration Date	:	01/24/2008
Last Update Date	:	05/24/2023

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