Provider Demographics
NPI:1285325688
Name:JEWSON, MAEGAN (PAC)
Entity type:Individual
Prefix:
First Name:MAEGAN
Middle Name:
Last Name:JEWSON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:748 OLD NORCROSS RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3394
Mailing Address - Country:US
Mailing Address - Phone:770-339-1500
Mailing Address - Fax:770-995-6172
Practice Address - Street 1:748 OLD NORCROSS RD STE 100
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3394
Practice Address - Country:US
Practice Address - Phone:770-339-1500
Practice Address - Fax:770-995-6172
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA11981363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant