MEDICARE: DR. MARGO RENEE ROLLINS 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
1	208000000X	Pediatrics Physician	067755	GA

General Provider Information

NPI Number	:	1992948111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGO RENEE ROLLINS M.D.

Provider Business Mailing Address
First Line	:	3450 BLAIR CIR NE
Second Line	:	APT 5213
City	:	ATLANTA
State	:	GA
Zip	:	30319-2241
Country	:	US
Telephone Number	:	770-364-2747
Fax Number	:

Provider Business Practice Location Address
First Line	:	3450 BLAIR CIR NE
Second Line	:	APT 5213
City	:	ATLANTA
State	:	GA
Zip	:	30319-2241
Country	:	US
Telephone Number	:	770-364-2747
Fax Number	:

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

Provider Enumeration Date	:	04/17/2009
Last Update Date	:	06/28/2013

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