Provider Demographics
NPI:1962408997
Name:PATTERSON, VERONICA MICHELLE (MD)
Entity type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:MICHELLE
Last Name:PATTERSON
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 1:641 HOSPITAL RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:COMMERCE
Mailing Address - State:GA
Mailing Address - Zip Code:30529-1155
Mailing Address - Country:US
Mailing Address - Phone:706-335-2777
Mailing Address - Fax:706-335-2788
Practice Address - Street 1:641 HOSPITAL RD
Practice Address - Street 2:SUITE 4
Practice Address - City:COMMERCE
Practice Address - State:GA
Practice Address - Zip Code:30529-1155
Practice Address - Country:US
Practice Address - Phone:706-335-2777
Practice Address - Fax:706-335-2788
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2017-06-26
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-20
Provider Licenses
StateLicense IDTaxonomies
GA043107207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000796551CMedicaid
GA000796551DMedicaid
GA000796551EMedicaid
GA000796551CMedicaid
GA000796551EMedicaid