Individual
EDIL JAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4547 BIRCH RIDGE TRL, STONE MOUNTAIN, GA 30083-5605
(404) 910-6174
Mailing address
4547 BIRCH RIDGE TRL, STONE MOUNTAIN, GA 30083-5605
(404) 910-6174
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0032041897
—
GA
Enumeration date
06/06/2018
Last updated
06/16/2018
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