Individual
JODI M. GREENWALD
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1285 HEMBREE RD, STE 100, ROSWELL, GA 30076-5715
(770) 442-1050
(770) 442-9618
Mailing address
1285 HEMBREE RD, STE 100, ROSWELL, GA 30076-5715
(770) 442-1050
(770) 442-9618
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
047218
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00840012D
—
GA
Enumeration date
06/24/2005
Last updated
07/08/2007
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