Provider Demographics
NPI:1780638627
Name:BELLAMY, SONYA (MD)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:
Last Name:BELLAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4360 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1049
Mailing Address - Country:US
Mailing Address - Phone:770-452-5667
Mailing Address - Fax:770-452-5677
Practice Address - Street 1:4360 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:SUITE 260
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-1049
Practice Address - Country:US
Practice Address - Phone:770-452-5667
Practice Address - Fax:770-452-5677
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2012-10-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA036098207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F44190Medicare UPIN