Healthcare Provider Details

I. General information

NPI: 1245449891
Provider Name (Legal Business Name): BROWN MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1123 RALPH DAVID ABERNATHY BLVD SW
ATLANTA GA
30310-1729
US

IV. Provider business mailing address

1123 RALPH DAVID ABERNATHY BLVD SW
ATLANTA GA
30310-1729
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 Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SANNAGAI ANDRIQUE BROWN
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 404-758-9300