Healthcare Provider Details

I. General information

NPI: 1508959602
Provider Name (Legal Business Name): JOI SANNE BROWN RICHMOND MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOI SANNE ANDREA BROWN MD

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 RALPH D ABERNATHY BLVD
ATLANTA GA
30310
US

IV. Provider business mailing address

1123 RALPH D ABERNATHY BLVD
ATLANTA GA
30310
US

V. Phone/Fax

Practice location:
  • Phone: 404-758-9300
  • Fax: 404-758-0798
Mailing address:
  • Phone: 404-758-9300
  • Fax: 404-758-0798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number32099
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: