Provider Demographics
NPI:1134181167
Name:FRITZ, ROBERT C (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:FRITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1415
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-0025
Mailing Address - Country:US
Mailing Address - Phone:770-476-7047
Mailing Address - Fax:770-476-5845
Practice Address - Street 1:3655 HOWELL FERRY RD STE 200
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3186
Practice Address - Country:US
Practice Address - Phone:770-476-7047
Practice Address - Fax:408-335-4730
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA22761208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00270014JMedicaid
GA110053188Medicare PIN
GA02BDBLVMedicare ID - Type Unspecified
GA00270014JMedicaid