Provider Demographics
NPI:1235170531
Name:INFECTIOUS DISEASE SPECIALISTS OF ATLANTA PC
Entity type:Organization
Organization Name:INFECTIOUS DISEASE SPECIALISTS OF ATLANTA PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:DRETLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-297-9755
Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6149
Mailing Address - Country:US
Mailing Address - Phone:404-297-9755
Mailing Address - Fax:404-297-5008
Practice Address - Street 1:2665 N DECATUR RD
Practice Address - Street 2:SUITE 330
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6149
Practice Address - Country:US
Practice Address - Phone:404-297-9755
Practice Address - Fax:404-297-5008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty