Provider Demographics
NPI:1508959602
Name:RICHMOND, JOI SANNE BROWN (MD)
Entity Type:Individual
Prefix:MRS
First Name:JOI SANNE
Middle Name:BROWN
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOI SANNE
Other - Middle Name:ANDREA
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1123 RALPH D ABERNATHY BLVD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30310
Mailing Address - Country:US
Mailing Address - Phone:404-758-9300
Mailing Address - Fax:404-758-0798
Practice Address - Street 1:1123 RALPH D ABERNATHY BLVD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310
Practice Address - Country:US
Practice Address - Phone:404-758-9300
Practice Address - Fax:404-758-0798
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA32099207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00413102AMedicaid
11BDBQBMedicare ID - Type Unspecified
E61587Medicare UPIN