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Individual

ROBERT G BAETEN II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
960 JOHNSON FERRY RD, STE 500, ATLANTA, GA 30342-1631
(404) 257-0006
(404) 851-1316
Mailing address
960 JOHNSON FERRY RD, STE 500, ATLANTA, GA 30342-1631
(404) 257-0006
(404) 851-1316

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4847
GA
363AM0700X
Medical Physician Assistant
621
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
233743781AG
GA
05
233743781S
GA
Enumeration date
07/21/2006
Last updated
02/03/2017
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