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NPI Code Detail

MEDICARE: DR. KOFI JULIAN ROBERTS PHARMD

MEDICARE: DR. KOFI JULIAN ROBERTS PHARMD
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
11835P1200XPharmacotherapy PharmacistRPH014362GA

General Provider Information

NPI Number : 1326362518
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KOFI JULIAN ROBERTS PHARMD
Provider Business Mailing Address
First Line : 2146 E LAKE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30307-1836
Country : US
Telephone Number : 404-259-8095
Fax Number :
Provider Business Practice Location Address
First Line : 2146 E LAKE RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30307-1836
Country : US
Telephone Number : 404-259-8095
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2010
Last Update Date : 03/17/2010

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