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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 4 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.

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Identifiers

StateTypeNumberIssuer
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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