MEDICARE: ROBIN GROCE STEAGALL R.D., L.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
1	133V00000X	Registered Dietitian	LD003075	GA
2	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian	003075	GA

General Provider Information

NPI Number	:	1518295161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN GROCE STEAGALL R.D., L.D.

Provider Business Mailing Address
First Line	:	11660 ALPHARETTA HWY STE 290
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-4963
Country	:	US
Telephone Number	:	404-446-3600
Fax Number	:	404-446-3609

Provider Business Practice Location Address
First Line	:	2700 ABBEY CT
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-6024
Country	:	US
Telephone Number	:	678-462-6629
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2009
Last Update Date	:	10/02/2020

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