Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 29478 | GA |
N | 207RC0000X | Internist - Cardiovascular Disease | 029478 | GA |
NPI | 1437192341 |
---|---|
Provider Name | Donald E Jansen |
First Address | Atlanta, GA 30342-1786 |
Second Address | Atlanta, GA 30342-1786 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 24/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00402982F | (05) | GA |
C17412 | (02) | GA |