Provider Demographics
NPI:1124692827
Name:JASTRZEMBSKI, MEGHAN ELIZABETH
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:ELIZABETH
Last Name:JASTRZEMBSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MARTIN ARMY COMMUNITY HOSPITAL-FM RESIDENCY
Mailing Address - Street 2:6600 VAN AALST BLVD BLDG 9250
Mailing Address - City:FORT BENNING
Mailing Address - State:GA
Mailing Address - Zip Code:31905
Mailing Address - Country:US
Mailing Address - Phone:762-408-2532
Mailing Address - Fax:762-408-2719
Practice Address - Street 1:MARTIN ARMY COMMUNITY HOSPITAL-FM RESIDENCY
Practice Address - Street 2:6600 VAN AALST BLVD BLDG 9250
Practice Address - City:FORT BENNING
Practice Address - State:GA
Practice Address - Zip Code:31905
Practice Address - Country:US
Practice Address - Phone:762-408-2532
Practice Address - Fax:762-408-2719
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2024-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC322717207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine