Provider Demographics
NPI:1982156857
Name:GAMBLE, ERICA
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 SUMMIT VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-5961
Mailing Address - Country:US
Mailing Address - Phone:678-600-4568
Mailing Address - Fax:
Practice Address - Street 1:4939 LOWER ROSWELL RD STE 202B
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-4384
Practice Address - Country:US
Practice Address - Phone:678-540-2488
Practice Address - Fax:770-202-2661
Is Sole Proprietor?:No
Enumeration Date:2016-10-26
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist