Individual
DR. SOPHIA BROTHERS PETERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
487 BURLINGTON RD NE, ATLANTA, GA 30307-1103
(404) 667-0482
(404) 378-1843
Mailing address
487 BURLINGTON RD NE, ATLANTA, GA 30307-1103
(404) 676-0482
(404) 378-1843
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
026913
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000369465N
—
GA
05
—
000925086F
—
GA
01
—
202G708830
RAILROAD MEDICARE
GA
01
—
3000122061
RAILROAD MEDICARE
GA
01
—
300122060
RAILROAD MEDICARE
GA
01
—
P00096724
RIALROAD MEDICARE
GA
Enumeration date
12/05/2005
Last updated
04/25/2018
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