MEDICARE: DR. ROBERT M MAZUR DC

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	111N00000X	Chiropractor	CHIR007376	GA

General Provider Information

NPI Number	:	1851374672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT M MAZUR DC

Provider Business Mailing Address
First Line	:	45 W CROSSVILLE RD
Second Line	:	SUITE 503
City	:	ROSWELL
State	:	GA
Zip	:	30075-2964
Country	:	US
Telephone Number	:	678-461-3512
Fax Number	:	678-461-3513

Provider Business Practice Location Address
First Line	:	45 W CROSSVILLE RD
Second Line	:	SUITE 503
City	:	ROSWELL
State	:	GA
Zip	:	30075-2964
Country	:	US
Telephone Number	:	678-461-3512
Fax Number	:	678-461-3513

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

Provider Enumeration Date	:	11/25/2005
Last Update Date	:	08/07/2007

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Directions to “ DR. ROBERT M MAZUR DC” Practice Location

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