Provider Demographics
NPI:1659562007
Name:RODNEY-SOMERSALL, CIDJAH (MD)
Entity Type:Individual
Prefix:MRS
First Name:CIDJAH
Middle Name:
Last Name:RODNEY-SOMERSALL
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 1:4525 TERESA CT
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-7702
Mailing Address - Country:US
Mailing Address - Phone:678-471-6938
Mailing Address - Fax:
Practice Address - Street 1:2695 BUFORD HWY NE
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3278
Practice Address - Country:US
Practice Address - Phone:404-616-6999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059751208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics