Provider Demographics
NPI:1992948111
Name:ROLLINS, MARGO RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:MARGO
Middle Name:RENEE
Last Name:ROLLINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 BLAIR CIR NE
Mailing Address - Street 2:APT 5213
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-2241
Mailing Address - Country:US
Mailing Address - Phone:770-364-2747
Mailing Address - Fax:
Practice Address - Street 1:3450 BLAIR CIR NE
Practice Address - Street 2:APT 5213
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-2241
Practice Address - Country:US
Practice Address - Phone:770-364-2747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA067755208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics