PETER R JUNGBLUT (NPI# 1104104686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104104686 |
| Entity Type | Individual |
| Full Name | PETER R JUNGBLUT |
| Credential | MD |
| Practice Address |
3747 Roswell Rd Ste 216 Marietta GA 30062 |
| Mailing Address |
3747 Roswell Rd Ste 216 Marietta GA 30062-6227 |
| Practice Telephone | 7709732272 |
| Mailing Telephone | 7709732272 |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2019-10-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 069056 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 805 Sandy Plains Rd, Marietta, GA 300666340 | 7707925015 | 7707921450 |
| Street Address |
3747 ROSWELL RD STE 216 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043288418 | Lloyd Damon Weddington | Internal Medicine | 3747 Roswell Rd Ste 216, Marietta, GA 30062-6227 | 2006-03-10 |
| 1639713217 | Aekta Patel | Physician Assistant | 3747 Roswell Rd Ste 216, Marietta, GA 30062-6227 | 2019-11-06 |
| 1720418841 | Jaime Gober | Family Medicine | 3747 Roswell Rd Ste 216, Marietta, GA 30062 | 2013-11-26 |
| 1912094046 | Travis Bowles | Pediatrics | 3747 Roswell Rd Ste 216, Marietta, GA 30062 | 2006-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790399475 | Janice Carol Gould | Internal Medicine | 140 Vann St Ne Ste 350, Marietta, GA 30060-8975 | 2020-09-01 |
| 1952914368 | Hardy Renew Wellness,llc | Internal Medicine | 838 Cannon Run Sw, Marietta, GA 30064-4600 | 2020-08-25 |
| 1881202752 | Zandoc Group Corp | Internal Medicine | 2759 Delk Rd Se Ste 1603, Marietta, GA 30067-8887 | 2020-07-16 |
| 1548892458 | Atlanta Osteoarthritis Center LLC | Internal Medicine | 2550 Windy Hill Rd Se Ste 308, Marietta, GA 30067-8655 | 2020-02-08 |
| 1952949893 | Dr Amy L Varner LLC | Internal Medicine | 1000 Johnson Ferry Rd Bldg E Ste 200, Marietta, GA 30068 | 2019-12-11 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1295392140 | Camden-clark Physician Corporation | Internal Medicine | 26 Acme St, Marietta, OH 45750-3306 | 2019-05-28 |
| 1821572447 | Cies Global - Georgia LLC | Internal Medicine | 780 Canton Rd Ne Ste 205, Marietta, GA 30060-7242 | 2018-09-19 |
| 1164943510 | David Hout Mason Jr. | Internal Medicine | 3615 Paper Mill Rd Se, Marietta, GA 30067-4938 | 2017-07-06 |
| 1942678628 | Claudia Michelle Brauer Ornelas | Internal Medicine | 401 Matthew St Dept Of, Marietta, OH 45750-1635 | 2015-09-11 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.