Gambello, Michael John
Gambello, Michael John is an individual health care provider with primary practice located at 2165 N Decatur Rd , Decatur GA 30033-5307. He recently has only one registered license in Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), which is considered as his primary health care specialty. Gambello, Michael John can be contacted via phone (404) 778-8570.Contact Information
Primary practice address
2165 N Decatur Rd
Decatur GA 30033-5307
Phone: (404) 778-8570
Fax: (404) 778-8562
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | 67568 | Georgia |
Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | L3304 | Texas |
Profile Details
NPI number | 1386671394 |
---|---|
LBN Legal business name | Gambello, Michael John |
Credentials | MD, PHD |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 26th, 2006 |
Last updated | Apr 24th, 2014 - about 10 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1386671394 | NPPES |
Georgia | MEDICAID | 003122764A | |
Georgia | Other | 147519602 | |
Georgia | MEDICAID | 147519602 | |
Georgia | Other | 8135N6 |
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