Provider Demographics
NPI:1376629451
Name:ROBBINS, LISA CAROLINA (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:CAROLINA
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1324 ROCKBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-3174
Mailing Address - Country:US
Mailing Address - Phone:770-564-1399
Mailing Address - Fax:770-564-1231
Practice Address - Street 1:1324 ROCKBRIDGE RD
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-3174
Practice Address - Country:US
Practice Address - Phone:770-564-1399
Practice Address - Fax:770-564-1231
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2014-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA038346207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0006160631Medicaid
GAF87769Medicare UPIN
GA11BDTCFMedicare ID - Type Unspecified