Walraven, Jamie W

Walraven, Jamie W is an individual health care provider with primary practice located at 105 Governors Sq Suite E, Fayetteville GA 30215-4866. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Walraven, Jamie W can be contacted via phone (678) 364-8414.

Contact Information

Primary practice address
105 Governors Sq Suite E Fayetteville GA 30215-4866
Phone: (678) 364-8414
Fax: (678) 364-8446
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 045023 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 045023 Georgia

Profile Details

NPI number 1750328738
LBN Legal business name Walraven, Jamie W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated May 7th, 2024 - about 6 months 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750328738 NPPES
Georgia MEDICAID 000817022D

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