DR. MICHAEL JOHN GAMBELLO MD PHD NPI 1386671394

NPI Information

NPI: 1386671394
Provider Name: DR. MICHAEL JOHN GAMBELLO, MD, PHD
Classification: Medical Genetics - 207SG0201X
Entity Type: Individual

Specialization: Clinical Genetics (M.D.)

PECOS Registration: Yes

Address:
2165 N DECATUR RD
DECATUR, GA
ZIP 30033
Phone: (404) 778-8570
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DR. Michael John Gambello, MD, PHD is a clinical genetics (m.d.) medical genetics in Decatur, GA with 31 years of experience. The provider is a clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders. DR. Michael John Gambello, MD, PHD NPI is 1386671394. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
Graduation Year:1993

The provider's business location address is:

2165 N DECATUR RD
DECATUR, GA
ZIP 30033-307
Phone: (404) 778-8570
Fax: (404) 778-8562

The NPI 1386671394 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/26/2006 and was last updated on 4/24/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207SG0201X	Medical Genetics	Clinical Genetics (M.D.)	L3304	TEXAS	No
2	207SG0201X	Medical Genetics	Clinical Genetics (M.D.)	67568	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G60741	MEDICARE UPIN	TEXAS
2	147519602	MEDICAID	TEXAS
3	147519602	OTHER	TENNESSEE	CSHCN
4	003122764A	MEDICAID	GEORGIA
5	8135N6	MEDICARE PIN	TEXAS
6	2021992225	MEDICARE UPIN	GEORGIA
7	370020673	MEDICARE PIN	TEXAS
8	8135N6	OTHER	TEXAS	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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