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NPI Code Detail

MEDICARE: LEE ROBERT ANISMAN M.D.

MEDICARE:   LEE ROBERT ANISMAN  M.D.
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
1207R00000XInternal Medicine Physician037939GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1037939OTHERGAMEDICAL LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174522023
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEE ROBERT ANISMAN M.D.
Provider Business Mailing Address
First Line : 145 15TH ST NE
Second Line : UNIT 1221
City : ATLANTA
State : GA
Zip : 30309-3535
Country : US
Telephone Number : 404-892-7960
Fax Number : 404-355-6370
Provider Business Practice Location Address
First Line : 3280 HOWELL MILL RD NW
Second Line : SUITE 326
City : ATLANTA
State : GA
Zip : 30327-4111
Country : US
Telephone Number : 404-355-3788
Fax Number : 404-355-6370
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 03/07/2023

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Directions to “ LEE ROBERT ANISMAN M.D.” Practice Location

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