Draviam, Rose P

Draviam, Rose P is an individual health care provider with primary practice located at 3011 Hampton Ave , Brunswick GA 31520-4264. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Draviam, Rose P can be contacted via phone (912) 261-2669.

Contact Information

Primary practice address
3011 Hampton Ave Brunswick GA 31520-4264
Phone: (912) 261-2669
Fax: (912) 261-0561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 049290 Georgia

Profile Details

NPI number 1205810884
LBN Legal business name Draviam, Rose P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Apr 29th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205810884 NPPES
Georgia MEDICAID 000886069A

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