Individual
JOSE M DONATIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1825 ROCKBRIDGE RD STE 15B, STONE MOUNTAIN, GA 30087-3306
(470) 444-3134
(470) 276-4370
Mailing address
PO BOX 740015, ATLANTA, GA 30374-0015
(312) 733-9730
(773) 866-8014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
88976
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009371000
—
FL
01
—
14S65
FLORIDA BLUE
FL
Enumeration date
06/15/2010
Last updated
11/18/2024
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