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Individual

ROBERT P HOLCOMB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
590 NANCY ST NW, MARIETTA, GA 30060-1334
(770) 423-0395
(770) 499-0352
Mailing address
590 NANCY ST NW, MARIETTA, GA 30060-1334
(770) 423-0395
(770) 499-0352

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
30096
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00461161A
GA
01
020045985
RAILROAD MEDICARE ID
GA
01
4137550
AETNA PPO ID
GA
01
52053447-001
BC/BS ID
GA
01
776018
AETNA HMO ID
GA
Enumeration date
05/01/2006
Last updated
12/03/2019
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