Provider Demographics
NPI:1285019018
Name:DELVA, GUENSLEY RALPH (MD)
Entity type:Individual
Prefix:MR
First Name:GUENSLEY
Middle Name:RALPH
Last Name:DELVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:880 HOLCOMB BRIDGE RD
Mailing Address - Street 2:BUILDING C SUITE 200
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1969
Mailing Address - Country:US
Mailing Address - Phone:678-841-7135
Mailing Address - Fax:
Practice Address - Street 1:1111 GLYNCO PKWY STE 300
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-7933
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH20073207L00000X
390200000X
GA86309207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program