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Dr. Jani Widjaja, MD
Diagnostic Radiology Physician in Lawrenceville, Georgia
NPI 1902881287

Jani Widjaja is a Diagnostic Radiology Physician based in Indianapolis, GA and is specialized in Diagnostic Radiology. Jani Widjaja practices in Lawrenceville, GA and has the professional credentials of MD. The NPI Number for Jani Widjaja is 1902881287 and holds a License No. 49221 (Georgia).

The current practice location address for Jani Widjaja is 1000 Medical Center Blvd, Lawrenceville, GA and can be reached out via phone at 770-995-4321.

Location: 1000 Medical Center Blvd, Lawrenceville, GA, 46206-1746
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902881287
Provider Name
Jani Widjaja
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1000 Medical Center Blvd, Lawrenceville, GA, 46206-1746
Phone Number
770-995-4321
Fax Number
Provider Enumeration Date
12/09/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000890447A 05 GA
institution
Provider Business Practice Location Address Details
Address
1000 Medical Center Blvd
City
Lawrenceville
State
Georgia
Zip
30045-7694
Phone Number
770-995-4321
Fax Number
person
Provider Business Mailing Address Details
Address
1000 Medical Center Blvd
City
Lawrenceville
State
Georgia
Zip
30045-7694
Phone Number
770-995-4321
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
49221 (Georgia)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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