Healthcare Provider Details

I. General information

NPI: 1235248931
Provider Name (Legal Business Name): SABRINA RENEE KENDRICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 09/22/2024
Certification Date: 09/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 PONCE DE LEON AVE NE
ATLANTA GA
30308-2012
US

IV. Provider business mailing address

101 WOODRUFF CIR SUITE 2101
ATLANTA GA
30322-0001
US

V. Phone/Fax

Practice location:
  • Phone: 404-616-2440
  • Fax:
Mailing address:
  • Phone: 404-712-2279
  • Fax: 404-712-2278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036-086141
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number036086141
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number35076
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: