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Individual

DR. ROBERT DAVID JANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
55 WHITCHER ST NE, STE 460, MARIETTA, GA 30060-1171
(770) 427-7389
(770) 427-2845
Mailing address
55 WHITCHER ST NE, STE 460, MARIETTA, GA 30060-1171
(770) 427-7389
(770) 427-2845

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
207RN0300X
Nephrology Physician
Primary
GA027578
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000332857AC
GA
05
000332857D
GA
05
000332857E
GA
05
000332857H
GA
05
000332857P
GA
05
000332857Q
GA
05
000332857U
GA
05
000332857V
GA
05
00332857A
GA
Enumeration date
06/14/2005
Last updated
12/10/2012
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