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General NPI Number Information
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NPI Number | 1437469822
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Entity Type | Individual
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Provider Name | HEIDI N ROBELLA P.A.
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Gender | Female
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 555 SUN VALLEY DR STE C1
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City | ROSWELL
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State | GA
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Zip | 30076-5621
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Country | US
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Telephone | 678-621-8100
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Fax | 844-313-9346
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Provider Business Mailing Address
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Address Line | 4299 TWO BRIDGE DR
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City | BUFORD
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State | GA
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Zip | 30518-1545
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Country | US
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Telephone | 423-284-6705
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 11825
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License Number State | GA
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