Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 62991 | GA |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 62991 | GA |
NPI | 1134343585 |
---|---|
Provider Name | Dr. Jennifer Christine Gottschalk |
First Address | Sandy Springs, GA 30328 |
Second Address | Sandy Springs, GA 30328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 01/11/2012 |