Individual
DR. JAZA MONIQUE MARINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2525 CUMBERLAND PARKWAY, KAISER PERMANENTE CUMBERLAND MEDICAL CENTER, ATLANTA, GA 30339
(770) 431-4107
(770) 431-4373
Mailing address
3495 PIEDMONT RD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305
(404) 364-7070
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
055267
GA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
055267
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
387570
BCBS - EAMC
GA
05
—
389254619A
—
GA
05
—
389254619C
—
GA
01
—
783527
BCBS - BCPHC
GA
Enumeration date
08/31/2006
Last updated
03/29/2022
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