Raviele, Kathleen M

Raviele, Kathleen M is an sole proprietor health care provider with primary practice located at 2799 Lawrenceville Hwy Suite 110, Decatur GA 30033-2517. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as her primary health care specialty. Raviele, Kathleen M can be contacted via phone (770) 491-0255.

Contact Information

Primary practice address
2799 Lawrenceville Hwy Suite 110 Decatur GA 30033-2517
Phone: (770) 491-0255
Fax: (770) 491-8157
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 020801 Georgia

Profile Details

NPI number 1508954298
LBN Legal business name Raviele, Kathleen M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 10th, 2006
Last updated Jul 8th, 2015 - about 9 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 1508954298 NPPES
Georgia MEDICAID 000179935C
Georgia Other 160056472
Georgia Other 7406947
Georgia Other 16BDCCB

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