Provider Demographics
NPI:1811282346
Name:ENGELBRECHT, JOHANNES D (MD)
Entity type:Individual
Prefix:
First Name:JOHANNES
Middle Name:D
Last Name:ENGELBRECHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 GORDON ST
Mailing Address - Street 2:
Mailing Address - City:BREMEN
Mailing Address - State:GA
Mailing Address - Zip Code:30110-1519
Mailing Address - Country:US
Mailing Address - Phone:770-537-1234
Mailing Address - Fax:770-537-1237
Practice Address - Street 1:1009 ALABAMA AVE S
Practice Address - Street 2:
Practice Address - City:BREMEN
Practice Address - State:GA
Practice Address - Zip Code:30110-2501
Practice Address - Country:US
Practice Address - Phone:678-821-6400
Practice Address - Fax:678-821-6401
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL33898207Q00000X
GA072259207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1861915647OtherGROUP NPI