Healthcare Provider Details

I. General information

NPI: 1487610846
Provider Name (Legal Business Name): ROBERT ANDREW SWERLICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 CLIFTON RD NE EMORY CLINIC, DEPARTMENT OF DERMATOLOGY
ATLANTA GA
30322-4200
US

IV. Provider business mailing address

1525 CLIFTON RD NE
ATLANTA GA
30322-4200
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-3681
  • Fax:
Mailing address:
  • Phone: 678-520-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number30906
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207NI0002X
TaxonomyClinical & Laboratory Dermatological Immunology Physician
License Number30906
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: