MEDICARE: ROBERT MONN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker

General Provider Information

NPI Number	:	1962098053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MONN

Provider Business Mailing Address
First Line	:	3525 PIEDMONT RD NE STE 620
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-1578
Country	:	US
Telephone Number	:	678-977-2176
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 PIEDMONT RD NE STE 620
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-1578
Country	:	US
Telephone Number	:	678-575-3570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/14/2020
Last Update Date	:	12/14/2020

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Directions to “ ROBERT MONN ” Practice Location

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