Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 22476 | GA |
NPI | 1033220561 |
---|---|
Provider Name | Dr. Robert Doyle Stulting |
First Address | Atlanta, GA 30328-4295 |
Second Address | Atlanta, GA 30328-4295 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E50858 | (02) |