Individual
DR. JENNIFER PORTER BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3300 BUCKEYE RD STE 178, ATLANTA, GA 30341-4232
(770) 458-6101
(770) 455-4008
Mailing address
3300 BUCKEYE RD STE 178, ATLANTA, GA 30341-4232
(770) 458-6101
(770) 455-4008
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
81345
GA
207ZP0101X
Anatomic Pathology Physician
Primary
81345
GA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
81345
GA
Other
Enumeration date
04/08/2013
Last updated
04/11/2019
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