MEDICARE: GEORGIA REPRODUCTIVE SPECIALISTS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1154446284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GEORGIA REPRODUCTIVE SPECIALISTS, LLC

Provider Business Mailing Address
First Line	:	9600 BLACKWELL ROAD
Second Line	:	SUITE 500
City	:	ROCKVILLE
State	:	MD
Zip	:	20850
Country	:	US
Telephone Number	:	301-340-1188
Fax Number	:	855-716-1603

Provider Business Practice Location Address
First Line	:	1100 LAKE HEARN DR STE 400
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1524
Country	:	US
Telephone Number	:	404-843-2229
Fax Number	:	404-843-0812

Authorized Official
Title or Position	:	EXECUTIVE MANAGING DIRECTOR
Name	:	VICKI GERBER
Credential	:
Telephone Number	:	301-545-1248

Provider Enumeration Date	:	03/20/2007
Last Update Date	:	10/06/2023

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