Individual
JAIMINI A DAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3870 MEDICAL PARK DRIVE SUITE 200, AUSTELL, GA 30106-1110
(770) 948-6824
(770) 948-6804
Mailing address
P.O. BOX 629, AUSTELL, GA 30168-1006
(770) 948-6824
(770) 948-6804
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
041103
GA
208VP0000X
Pain Medicine Physician
Primary
041103
GA
Other
Enumeration date
08/31/2006
Last updated
01/24/2011
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