Healthcare Provider Details

I. General information

NPI: 1518295161
Provider Name (Legal Business Name): ROBIN GROCE STEAGALL R.D., L.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2009
Last Update Date: 10/02/2020
Certification Date: 10/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 ABBEY CT
ALPHARETTA GA
30004-6024
US

IV. Provider business mailing address

11660 ALPHARETTA HWY STE 290
ROSWELL GA
30076-4963
US

V. Phone/Fax

Practice location:
  • Phone: 678-462-6629
  • Fax:
Mailing address:
  • Phone: 404-446-3600
  • Fax: 404-446-3609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD003075
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number003075
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: