Provider Demographics
NPI:1205841046
Name:PLEASANT, SHYRONDA YVETTE (MD)
Entity Type:Individual
Prefix:DR
First Name:SHYRONDA
Middle Name:YVETTE
Last Name:PLEASANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1298 WELLBROOK CIR NE STE A
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-8031
Mailing Address - Country:US
Mailing Address - Phone:770-648-6620
Mailing Address - Fax:770-679-0559
Practice Address - Street 1:1298 WELLBROOK CIR NE STE A
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-8031
Practice Address - Country:US
Practice Address - Phone:770-648-6620
Practice Address - Fax:770-679-0559
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051999208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GABP7962930OtherDEA NUMBER
GA000960429AMedicaid