Grave De Peralta, Jose M
Grave De Peralta, Jose M is an individual health care provider with primary practice located at 509 Gordon Ave , Thomasville GA 31792-6645. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Grave De Peralta, Jose M can be contacted via phone (229) 226-7544.Contact Information
Primary practice address
509 Gordon Ave
Thomasville GA 31792-6645
Phone: (229) 226-7544
Fax: (229) 226-0314
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 038238 | Georgia |
Profile Details
| NPI number | 1033186838 |
|---|---|
| LBN Legal business name | Grave De Peralta, Jose M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2006 |
| Last updated | Jan 12th, 2011 - about 15 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 | 1033186838 | NPPES |
| Georgia | MEDICAID | 000600553D | |
| Georgia | MEDICAID | 000600553C |
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