Provider Demographics
NPI:1760406383
Name:PYBURN, ROBIN R (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:R
Last Name:PYBURN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:35 COLLIER RD NW
Mailing Address - Street 2:SUITE M200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1613
Mailing Address - Country:US
Mailing Address - Phone:404-355-0763
Mailing Address - Fax:404-355-0773
Practice Address - Street 1:35 COLLIER RD NW
Practice Address - Street 2:SUITE M200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1613
Practice Address - Country:US
Practice Address - Phone:404-355-0763
Practice Address - Fax:404-355-0773
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022867207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA110214260OtherRAILROAD MCR FOR R.PYBURN
GA004027OtherBCBS FOR ROBIN PYBURN
GAD30533Medicare UPIN
GA110214260OtherRAILROAD MCR FOR R.PYBURN