Berendt, Jason
Berendt, Jason is an individual health care provider with primary practice located at 1445 Old Mcdonough Hwy Se Ste E , Conyers GA 30094-5977. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Berendt, Jason can be contacted via phone (770) 922-9222.Contact Information
Primary practice address
1445 Old Mcdonough Hwy Se Ste E
Conyers GA 30094-5977
Phone: (770) 922-9222
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 23298 | South Carolina |
Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 23298 | South Carolina |
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 067390 | Georgia |
Profile Details
NPI number | 1245266782 |
---|---|
LBN Legal business name | Berendt, Jason |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 25th, 2006 |
Last updated | Mar 15th, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1245266782 | NPPES |
South Carolina | Other | 571020809027 | TRICARE SC |
South Carolina | Other | P00125604 | TRICARE SC |
South Carolina | MEDICAID | 232983 | TRICARE SC |
South Carolina | Other | 571020809032 | TRICARE SC |
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