Provider Demographics
NPI:1275562332
Name:SEJOUR DONATIEN, JODINE MADLINE (MD)
Entity Type:Individual
Prefix:DR
First Name:JODINE
Middle Name:MADLINE
Last Name:SEJOUR DONATIEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6085 OLD NATIONAL HWY STE EG
Mailing Address - Street 2:
Mailing Address - City:SOUTH FULTON
Mailing Address - State:GA
Mailing Address - Zip Code:30349-4333
Mailing Address - Country:US
Mailing Address - Phone:470-754-6360
Mailing Address - Fax:877-780-7359
Practice Address - Street 1:6085 OLD NATIONAL HWY STE EG
Practice Address - Street 2:
Practice Address - City:SOUTH FULTON
Practice Address - State:GA
Practice Address - Zip Code:30349-4333
Practice Address - Country:US
Practice Address - Phone:470-754-6360
Practice Address - Fax:877-780-7359
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME94380207Q00000X
GA88994207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003258208AMedicaid