Healthcare Provider Details

I. General information

NPI: 1205121985
Provider Name (Legal Business Name): GIORGIO A. ROCCARO MD MSCE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2011
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE FL 6
ATLANTA GA
30322
US

IV. Provider business mailing address

1365 CLIFTON RD NE FL 6
ATLANTA GA
30322-1013
US

V. Phone/Fax

Practice location:
  • Phone: 855-366-7989
  • Fax:
Mailing address:
  • Phone: 855-366-7989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number256994
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number79712
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number79712
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207RT0003X
TaxonomyTransplant Hepatology Physician
License Number79712
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: