Healthcare Provider Details

I. General information

NPI: 1568576890
Provider Name (Legal Business Name): NICOLE M HROBOWSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: NICOLE M DAVIS, DAVIS-HROBOWSKI MD

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 11/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FERRY ROAD NE KAISER PERMANENTE AT NORTHSIDE HOSPITAL
ATLANTA GA
30342
US

IV. Provider business mailing address

3495 PIEDMONT ROAD, NE NINE PIEDMONT CENTER
ATLANTA GA
30305
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-8000
  • Fax:
Mailing address:
  • Phone: 404-364-7070
  • Fax: 202-559-6071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD036673
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number074939
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number200232
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD036673
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: