Provider Demographics
NPI:1982653572
Name:CLABBY, MARTHA L (MD)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:L
Last Name:CLABBY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2835 BRANDYWINE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-5510
Mailing Address - Country:US
Mailing Address - Phone:770-488-9212
Mailing Address - Fax:770-488-9408
Practice Address - Street 1:1400 TULLIE ROAD SUITE 630
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1015
Practice Address - Country:US
Practice Address - Phone:404-256-2593
Practice Address - Fax:770-488-9408
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2021-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA0500952080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00907893AMedicaid
G86172Medicare UPIN
37BBFWJMedicare ID - Type Unspecified