De Gourville, Robert Everett
De Gourville, Robert Everett is an individual health care provider with primary practice located at 777 Cleveland Ave Sw #400, Atlanta GA 30315-7129. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. De Gourville, Robert Everett can be contacted via phone (404) 766-3337.Contact Information
Primary practice address
777 Cleveland Ave Sw #400
Atlanta GA 30315-7129
Phone: (404) 766-3337
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 034572 | Georgia |
Profile Details
| NPI number | 1598718744 |
|---|---|
| LBN Legal business name | De Gourville, Robert Everett |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 18th, 2006 |
| Last updated | Jul 25th, 2008 - about 18 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 | 1598718744 | NPPES |
| Georgia | MEDICAID | 30833819D |
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