Tavolieri, Nathan David
Tavolieri, Nathan David is an individual health care provider with primary practice located at 300 W Hospital Rd Building 329, Fort Gordon GA 30905-5741. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Tavolieri, Nathan David can be contacted via phone (706) 787-3805.Contact Information
Primary practice address
300 W Hospital Rd Building 329
Fort Gordon GA 30905-5741
Phone: (706) 787-3805
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA9103339 | Florida |
Profile Details
| NPI number | 1063473510 |
|---|---|
| LBN Legal business name | Tavolieri, Nathan David |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Oct 3rd, 2013 - about 11 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 | 1063473510 | NPPES |
| Florida | MEDICAID | 2921839-00 |
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