Healthcare Provider Details

I. General information

NPI: 1639090665
Provider Name (Legal Business Name): DIGESTIVE HEALTHCARE OF GA, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 CHEROKEE ST NE STE 100
MARIETTA GA
30060-8930
US

IV. Provider business mailing address

3280 HOWELL MILL RD NW STE T100
ATLANTA GA
30327-4122
US

V. Phone/Fax

Practice location:
  • Phone: 404-425-5570
  • Fax: 404-974-9596
Mailing address:
  • Phone: 404-355-3200
  • Fax: 404-350-8795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: PROF. SHELLY M ROBINSON
Title or Position: DIRECTOR OF NCIS
Credential: PHD
Phone: 770-490-5009