institution
Kathleen M. Raviele, Md Pc
Gynecology Physician in Decatur, Georgia
NPI 1316296411

Kathleen M. Raviele, Md Pc is a Gynecology Physician based in Decatur, GA and is specialized in Gynecology. Kathleen M. Raviele, Md Pc practices in Decatur, GA. The NPI Number for Kathleen M. Raviele, Md Pc is 1316296411 and holds a License No. 020801 (Georgia).

The current practice location address for Kathleen M. Raviele, Md Pc is 2799 Lawrenceville Hwy, Decatur, GA and can be reached out via phone at 770-491-0255 and via fax at 770-491-8157.

Location: 2799 Lawrenceville Hwy, Decatur, GA, 30033-2517
institution
Provider Profile Details
NPI Number
1316296411
Provider Name
Kathleen M. Raviele, Md Pc
Credential
Provider Entity Type
Organization
Address
2799 Lawrenceville Hwy, Decatur, GA, 30033-2517
Phone Number
770-491-0255
Fax Number
770-491-8157
Provider Enumeration Date
09/05/2012
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000179935C 05 GA
16BDCCB 01 GA MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
2799 Lawrenceville Hwy
City
State
Zip
30033-2517
Phone Number
770-491-0255
Fax Number
770-491-8157
person
Provider Business Mailing Address Details
Address
2799 Lawrenceville Hwy
City
State
Zip
30033-2517
Phone Number
770-491-0255
Fax Number
770-491-8157
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
Gynecology
Taxonomy
License No.
020801 (Georgia)
Definition
Definition to come...
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