Provider Demographics
NPI:1780884544
Name:MILATOU, RODOTHEA (MD)
Entity type:Individual
Prefix:
First Name:RODOTHEA
Middle Name:
Last Name:MILATOU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 HOLCOMB BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1906
Mailing Address - Country:US
Mailing Address - Phone:770-998-0605
Mailing Address - Fax:770-587-3528
Practice Address - Street 1:900 HOLCOMB BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1906
Practice Address - Country:US
Practice Address - Phone:770-998-0605
Practice Address - Fax:770-587-3528
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0437132083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE74048Medicare UPIN