Healthcare Provider Details

I. General information

NPI: 1205360732
Provider Name (Legal Business Name): RODNEYSHA BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1513 CLEVELAND AVE BLDG 500
ATLANTA GA
30344-6949
US

IV. Provider business mailing address

1513 CLEVELAND AVE BLDG 500
ATLANTA GA
30344-6949
US

V. Phone/Fax

Practice location:
  • Phone: 404-756-1422
  • Fax: 404-756-1480
Mailing address:
  • Phone: 404-756-1422
  • Fax: 404-756-1480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number86000
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: