Provider Demographics
NPI:1104925106
Name:SYLVAIN, GAYLA DENISE (MD)
Entity type:Individual
Prefix:DR
First Name:GAYLA
Middle Name:DENISE
Last Name:SYLVAIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1325 ROCK QUARRY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5088
Mailing Address - Country:US
Mailing Address - Phone:770-389-0734
Mailing Address - Fax:770-389-5364
Practice Address - Street 1:1325 ROCK QUARRY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5088
Practice Address - Country:US
Practice Address - Phone:770-389-0734
Practice Address - Fax:770-389-5364
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2013-12-18
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Provider Licenses
StateLicense IDTaxonomies
GA039958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG54576Medicare UPIN
GA11SCGXTMedicare PIN