Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01064328A | IN |
N | 111NI0900X | Internist | 01064328A | IN |
N | 2080A0000X | Adolescent Medicine | 01064328 | IN |
NPI | 1245258599 |
---|---|
Provider Name | Theresa M Rohr-Kirchgraber |
First Address | Athens, GA 30604-8089 |
Second Address | Athens, GA 30606-2165 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 28/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F27498 | (02) | IN |