Individual
REBECCA B. KLISOVIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1280
(404) 778-3932
(404) 778-4755
Mailing address
1365 CLIFTON RD NE STE C5004, ATLANTA, GA 30322-1013
(404) 778-3932
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
35079648
OH
207RX0202X
Medical Oncology Physician
Primary
78405
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2282239
—
OH
Enumeration date
07/31/2006
Last updated
08/21/2017
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