Provider Demographics
NPI:1972886414
Name:JAWHAR, FIREE A (PHD)
Entity type:Individual
Prefix:DR
First Name:FIREE
Middle Name:A
Last Name:JAWHAR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 SHADOW RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-4759
Mailing Address - Country:US
Mailing Address - Phone:770-469-0503
Mailing Address - Fax:
Practice Address - Street 1:3505 CENTERVILLE HWY
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30039-6405
Practice Address - Country:US
Practice Address - Phone:770-736-2157
Practice Address - Fax:770-736-9340
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist