Provider Demographics
NPI:1316105166
Name:CAMILO AND ELIZABETH GABIANA MDS
Entity type:Organization
Organization Name:CAMILO AND ELIZABETH GABIANA MDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:V
Authorized Official - Last Name:GABIANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-323-4747
Mailing Address - Street 1:700 CENTER ST
Mailing Address - Street 2:201 PROFESSIONAL TOWER
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-1546
Mailing Address - Country:US
Mailing Address - Phone:706-323-4747
Mailing Address - Fax:706-660-0676
Practice Address - Street 1:700 CENTER ST
Practice Address - Street 2:201 PROFESSIONAL TOWER
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901-1546
Practice Address - Country:US
Practice Address - Phone:706-323-4747
Practice Address - Fax:706-660-0676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA29645207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD29520Medicare UPIN
GAA61447Medicare UPIN