MEDICARE: JERLYN ROZIER-RAYAM

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	213E00000X	Podiatrist	682	GA

General Provider Information

NPI Number	:	1790945939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERLYN ROZIER-RAYAM

Provider Business Mailing Address
First Line	:	565 RUNNING FAWN DR
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-4101
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5885 CUMMING HWY
Second Line	:	STE 108-184
City	:	SUGAR HILL
State	:	GA
Zip	:	30518-5765
Country	:	US
Telephone Number	:	770-444-1241
Fax Number	:	800-899-6826

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

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/11/2008

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Directions to “ JERLYN ROZIER-RAYAM ” Practice Location

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