Provider Demographics
NPI:1083606172
Name:DOAN, ROBERT B (PA C)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:B
Last Name:DOAN
Suffix:
Gender:M
Credentials:PA C
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Mailing Address - Street 1:2001 PEACHTREE RD NE
Mailing Address - Street 2:STE 705
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1476
Mailing Address - Country:US
Mailing Address - Phone:404-355-0743
Mailing Address - Fax:404-355-2136
Practice Address - Street 1:2045 PEACHTREE RD NE
Practice Address - Street 2:STE 700
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1414
Practice Address - Country:US
Practice Address - Phone:404-355-0743
Practice Address - Fax:404-603-9887
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2008-02-04
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Provider Licenses
StateLicense IDTaxonomies
GA003300363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10729OtherKAISER PERMANENTE
GAI 7 WCFGPMedicare ID - Type Unspecified
GAI7WCFGPMedicare PIN