MEDICARE: DR. JACOB NOAH GREENBERG 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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	85565	GA
2	208000000X	Pediatrics Physician	85565	GA

General Provider Information

NPI Number	:	1649699240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB NOAH GREENBERG M.D.

Provider Business Mailing Address
First Line	:	PO BOX 422002
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-9002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 JOHNSON FY RD NE
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30342-1605
Country	:	US
Telephone Number	:	404-785-5437
Fax Number	:

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

Provider Enumeration Date	:	04/10/2014
Last Update Date	:	11/04/2025

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Directions to “ DR. JACOB NOAH GREENBERG M.D.” Practice Location

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