Shoumou, Jean Gustave
Shoumou, Jean Gustave is an individual health care provider with primary practice located at 2801 Dekalb Medical Parkway , Lithonia GA 30058. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Hospitalist is his primary health care specialty. Shoumou, Jean Gustave can be contacted via phone (404) 501-8492.Contact Information
Primary practice address
2801 Dekalb Medical Parkway
Lithonia GA 30058
Phone: (404) 501-8492
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 062772 | Georgia |
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | 062772 | Georgia |
| Allopathic & Osteopathic Physicians / Hospitalist | 208M00000X | 062772 | Georgia |
Profile Details
| NPI number | 1063619195 |
|---|---|
| LBN Legal business name | Shoumou, Jean Gustave |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2007 |
| Last updated | Jan 30th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063619195 | NPPES |
| Georgia | MEDICAID | 003104725C |
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