Provider Demographics
NPI:1104098250
Name:MINNIS, JAMIL ANGELO (MD)
Entity type:Individual
Prefix:DR
First Name:JAMIL
Middle Name:ANGELO
Last Name:MINNIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:720 WESTVIEW DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310-1458
Mailing Address - Country:US
Mailing Address - Phone:404-616-1692
Mailing Address - Fax:404-616-4131
Practice Address - Street 1:80 JESSE HILL JR DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3031
Practice Address - Country:US
Practice Address - Phone:404-616-1692
Practice Address - Fax:404-616-4131
Is Sole Proprietor?:No
Enumeration Date:2008-03-28
Last Update Date:2008-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA001611207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology