Healthcare Provider Details

I. General information

NPI: 1033995691
Provider Name (Legal Business Name): ROBIN SWEENEY CSFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2023
Last Update Date: 09/07/2023
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CAMPBELL HILL ST NW STE 280
MARIETTA GA
30060-1162
US

IV. Provider business mailing address

PO BOX 931914
ATLANTA GA
31193-1914
US

V. Phone/Fax

Practice location:
  • Phone: 770-485-7628
  • Fax: 214-764-0880
Mailing address:
  • Phone: 214-227-2457
  • Fax: 214-764-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number193757
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: