Healthcare Provider Details

I. General information

NPI: 1275736902
Provider Name (Legal Business Name): MELANIE JOHNSON POINTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELANIE JEANNINE JOHNSON MD

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 DANNON VW SW SUITE 3202
ATLANTA GA
30331-2157
US

IV. Provider business mailing address

3423 COVINGTON DR STE B
DECATUR GA
30032-1837
US

V. Phone/Fax

Practice location:
  • Phone: 404-346-3471
  • Fax:
Mailing address:
  • Phone: 404-286-9252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number68037
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2012-01382
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-17357
License Number StateHI
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2012-01382
License Number StateNC
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD-17357
License Number StateHI
# 6
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number68037
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: