Provider Demographics
NPI:1023053329
Name:ROZIN, SPENCER I (MD FACP)
Entity type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:I
Last Name:ROZIN
Suffix:
Gender:M
Credentials:MD FACP
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Other - Credentials:
Mailing Address - Street 1:721 WELLNESS WAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3304
Mailing Address - Country:US
Mailing Address - Phone:770-709-0900
Mailing Address - Fax:770-709-7444
Practice Address - Street 1:721 WELLNESS WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3304
Practice Address - Country:US
Practice Address - Phone:770-709-0900
Practice Address - Fax:770-709-7444
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2010-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA034236207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF03569Medicare UPIN