Individual
DR. JEFFREY DESALVO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041-7659
(770) 844-3200
(404) 851-6325
Mailing address
1200 NORTHSIDE FORSYTH DR, CUMMING, GA 30041-7659
(770) 844-3200
(404) 851-6325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54264
GA
208M00000X
Hospitalist Physician
Primary
054264
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
932960763J
—
GA
Enumeration date
10/10/2006
Last updated
01/19/2017
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