Individual
DR. JEREMY AGUINALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
720 WESTVIEW DR SW, ATLANTA, GA 30310-1458
(404) 752-1500
Mailing address
180 EMERY HWY, MACON, GA 31217-3656
(478) 464-0612
(478) 464-0002
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
80804
GA
390200000X
Student in an Organized Health Care Education/Training Program
80804
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003259332C
—
GA
Enumeration date
05/11/2017
Last updated
09/01/2022
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