Provider Demographics
NPI:1104838697
Name:GABIANELLI, EUGENE B (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:B
Last Name:GABIANELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2247
Mailing Address - Country:US
Mailing Address - Phone:404-897-6810
Mailing Address - Fax:404-897-4924
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE 1500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-897-6810
Practice Address - Fax:404-897-4924
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA035629207W00000X
GA042043207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA180035907OtherRAILROAD MEDICARE
GA00495558DMedicaid
GA18BDFNBMedicare PIN
GA00495558DMedicaid