Provider Demographics
NPI:1245015981
Name:FAIRMAN, ROBERT THOMAS (PHD, MPH, CHES)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:THOMAS
Last Name:FAIRMAN
Suffix:
Gender:M
Credentials:PHD, MPH, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PARKWAY PL SE STE 927
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-8293
Mailing Address - Country:US
Mailing Address - Phone:704-906-7857
Mailing Address - Fax:
Practice Address - Street 1:1800 PARKWAY PL SE STE 927
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8293
Practice Address - Country:US
Practice Address - Phone:704-906-7857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
27949174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator