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General NPI Number Information
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NPI Number | 1568576866
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Entity Type | Individual
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Provider Name | ROBERT DEIMLER D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 3555 CENTERVILLE HWY SUITE 100
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City | SNELLVILLE
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State | GA
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Zip | 30039-6456
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Country | US
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Telephone | 770-985-9957
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Fax | 770-985-9959
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Provider Business Mailing Address
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Address Line | PO BOX 934915
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City | ATLANTA
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State | GA
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Zip | 31193-4915
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Country | US
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Telephone | 404-501-7969
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Fax | 404-501-3874
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 038728
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License Number State | GA
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