Provider Demographics
NPI:1588661623
Name:KAMEAN, JEFFRIE L (MD)
Entity type:Individual
Prefix:
First Name:JEFFRIE
Middle Name:L
Last Name:KAMEAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 88587
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30356-8587
Mailing Address - Country:US
Mailing Address - Phone:404-299-8320
Mailing Address - Fax:404-299-3478
Practice Address - Street 1:2675 NORTH DECATUR ROAD
Practice Address - Street 2:SUITE 305
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6125
Practice Address - Country:US
Practice Address - Phone:404-299-8320
Practice Address - Fax:404-299-3478
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2013-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA40115207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG15148OtherCOVENTRY
GA582662703OtherMAMSI LIFE AND HEALTH INS
GA00676035FMedicaid
GA582662703OtherHUMANA
GA582662703OtherGOLDEN RULE INSURANCE
GA160041XXOtherPREFERRED CARE PROVIDER N
GA312895OtherBLUE CROSS BLUE SHEILD
GA582662703OtherHUMANA
GA582662703OtherGOLDEN RULE INSURANCE
GAG15148Medicare UPIN