MEDICARE: ROBERT KUO

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	207Q00000X	Family Medicine Physician	34.012966	OH
2	207Q00000X	Family Medicine Physician	89773	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801208657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT KUO

Provider Business Mailing Address
First Line	:	3699 CASCADE RD SW STE B2
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2163
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3699 CASCADE RD SW STE B2
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-2163
Country	:	US
Telephone Number	:	404-691-7006
Fax Number	:

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

Provider Enumeration Date	:	05/28/2014
Last Update Date	:	10/13/2021

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