Individual
ROBERT EVERETT DE GOURVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
777 CLEVELAND AVE SW, #400, ATLANTA, GA 30315-7129
(404) 766-3337
Mailing address
777 CLEVELAND AVE SW, #400, ATLANTA, GA 30315-7129
(404) 766-3337
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
034572
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30833819D
—
GA
Enumeration date
05/18/2006
Last updated
07/25/2008
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