Provider Demographics
NPI:1306828355
Name:ROBACH, ERIC M (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:ROBACH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 HOG MOUNTAIN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:WATKINSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30677-1935
Mailing Address - Country:US
Mailing Address - Phone:706-705-6465
Mailing Address - Fax:706-471-1919
Practice Address - Street 1:1800 HOG MOUNTAIN RD STE 101
Practice Address - Street 2:
Practice Address - City:WATKINSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30677-1935
Practice Address - Country:US
Practice Address - Phone:706-705-6465
Practice Address - Fax:706-471-1919
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA064062207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2042398Medicare ID - Type Unspecified
I35473Medicare UPIN