Provider Demographics
NPI:1518295161
Name:STEAGALL, ROBIN GROCE (RD, LD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:GROCE
Last Name:STEAGALL
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11660 ALPHARETTA HWY STE 290
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4963
Mailing Address - Country:US
Mailing Address - Phone:404-446-3600
Mailing Address - Fax:404-446-3609
Practice Address - Street 1:2700 ABBEY CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6024
Practice Address - Country:US
Practice Address - Phone:678-462-6629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-19
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALD003075133V00000X
GA003075133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered