Healthcare Provider Details

I. General information

NPI: 1134317993
Provider Name (Legal Business Name): ROBERT LEWIS MESSER RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2007
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 SAWNEE TRL
CUMMING GA
30041-8448
US

IV. Provider business mailing address

1890 SAWNEE TRL
CUMMING GA
30041-8448
US

V. Phone/Fax

Practice location:
  • Phone: 770-241-6086
  • Fax:
Mailing address:
  • Phone: 770-241-6086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number001830
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: