Individual
DR. JAMIE W WALRAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2037 COMMERCE DR N, PEACHTREE CITY, GA 30269-3538
(678) 364-8414
(678) 545-0146
Mailing address
105 GOVERNORS SQ, SUITE E, FAYETTEVILLE, GA 30215-4866
(678) 364-8414
(678) 364-8446
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
045023
GA
207Q00000X
Family Medicine Physician
045023
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000817022D
—
GA
Enumeration date
05/31/2006
Last updated
07/03/2025
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