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NPI Code Detail

MEDICARE: DR. JONATHAN CHARLES FRUENDT M.D

MEDICARE:  DR. JONATHAN CHARLES FRUENDT  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
1207R00000XInternal Medicine Physician14416AL

General Provider Information

NPI Number : 1861482242
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN CHARLES FRUENDT M.D
Provider Business Mailing Address
First Line : 7395 MOBLEY CT
Second Line :
City : WINSTON
State : GA
Zip : 30187-2233
Country : US
Telephone Number : 678-838-7687
Fax Number : 404-464-8200
Provider Business Practice Location Address
First Line : 1401 DESHLER ST SW
Second Line :
City : ATLANTA
State : GA
Zip : 30330-1040
Country : US
Telephone Number : 404-464-8212
Fax Number : 404-464-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 07/08/2007

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Directions to “ DR. JONATHAN CHARLES FRUENDT M.D” Practice Location

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