Provider Demographics
NPI:1922005487
Name:BLASBERG, ROBERT D (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:BLASBERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5901A PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:STE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5382
Mailing Address - Country:US
Mailing Address - Phone:678-892-2020
Mailing Address - Fax:678-538-1950
Practice Address - Street 1:5995 BARFIELD RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4411
Practice Address - Country:US
Practice Address - Phone:404-256-1507
Practice Address - Fax:404-256-1981
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2013-11-15
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Provider Licenses
StateLicense IDTaxonomies
GA026223207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00656235AMedicaid
GA180032092OtherRR MEDICARE
GA294428OtherWELLCARE
GA1078920002OtherDME
GA154029OtherBCBS
GA4105767OtherAETNA
GA479732OtherAETNA HMO
GA582209517OtherWORK COMP
GA02372OtherCOVENTRY PPO
GA108374OtherCOVENTRY HMO
GA0890550OtherUHC
GA00656235AMedicaid
GA582209517OtherWORK COMP
GA180032092OtherRR MEDICARE