Individual
DR. ROBERD MANER BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
OF EPIDEMIOLOGY, 1518 CLIFTON ROAD NE, ATLANTA, GA 30322-4201
(404) 727-2671
(404) 727-8737
Mailing address
OF EPIDEMIOLOGY, 1518 CLIFTON ROAD NE, ATLANTA, GA 30322-4201
(404) 727-2671
(404) 727-8737
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
057435
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
057435
STATE MED. LIC. NO.
GA
01
—
31896
STATE MED. LIC. NO.
MN
01
—
8373
STATE MED. LIC. NO.
SC
01
—
9401136
STATE MED. LIC. NO.
NC
Enumeration date
05/21/2007
Last updated
03/07/2023
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