Provider Demographics
NPI:1275584047
Name:STOLTZ, ROBERT A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:STOLTZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1100 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 593
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1709
Mailing Address - Country:US
Mailing Address - Phone:404-255-9096
Mailing Address - Fax:404-255-9097
Practice Address - Street 1:114 CHERRY ST NE
Practice Address - Street 2:SUITE F
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-7277
Practice Address - Country:US
Practice Address - Phone:770-218-1888
Practice Address - Fax:770-218-0093
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2010-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA058018174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH55300Medicare UPIN