Provider Demographics
NPI:1528043338
Name:PATTERSON, GLENDA MARIE (MD)
Entity Type:Individual
Prefix:
First Name:GLENDA
Middle Name:MARIE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:75 PIEDMONT AVE
Mailing Address - Street 2:STE 700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-756-1480
Mailing Address - Fax:404-756-1489
Practice Address - Street 1:80 JESSIE HILL JR DR
Practice Address - Street 2:PULMONARY CLINIC FIRST FLOOR
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303
Practice Address - Country:US
Practice Address - Phone:404-616-2503
Practice Address - Fax:404-616-5933
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2020-02-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA025012207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0121557Medicaid
E01152Medicare UPIN