Healthcare Provider Details

I. General information

NPI: 1497059612
Provider Name (Legal Business Name): XIOMARA IVETTE BROWN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CLIFTON RD NE
ATLANTA GA
30329-4018
US

IV. Provider business mailing address

6202 JEFFERSON CIR S
CHAMBLEE GA
30341-2662
US

V. Phone/Fax

Practice location:
  • Phone: 404-398-2957
  • Fax:
Mailing address:
  • Phone: 443-722-4345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number21139
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: