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Individual

JONATHAN DAVID PEWITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
835 COGBURN AVENUE, SUITE 100, MARIETTA, GA 30060-1008
(770) 422-5557
(770) 422-5456
Mailing address
835 COGBURN AVENUE, SUITE 250, MARIETTA, GA 30060-1010
(770) 422-8815
(770) 422-8816

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
065413
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003108826A
GU
Enumeration date
08/06/2007
Last updated
03/30/2023
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