Individual
MS. ALYSHA S JAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2536 LAWRENCEVILLE HWY, DECATUR, GA 30033-3227
(770) 934-6832
(770) 934-6337
Mailing address
755 WALTHER RD, LAWRENCEVILLE, GA 30046-8725
(770) 290-8087
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
001615
GA
207P00000X
Emergency Medicine Physician
1615
GA
363AM0700X
Medical Physician Assistant
Primary
005146
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225403045 A & B
—
GA
Enumeration date
09/07/2007
Last updated
09/30/2020
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