Individual
DR. TIMOTHY BONITTO BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
83 UPPER RIVERDALE ROAD, SUITE 135, RIVERDALE, GA 30274
(770) 991-0778
(770) 991-7390
Mailing address
83 UPPER RIVERDALE ROAD, SUITE 135, RIVERDALE, GA 30274
(770) 991-0778
(770) 991-7390
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
032110
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000416116L
—
GA
01
—
912295
BLUE CROSS BLUE SHIELD GA
GA
01
—
E83158
COVENTRY HEALTH INSURANCE
GA
Enumeration date
03/29/2006
Last updated
11/14/2011
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