Provider Demographics
NPI:1467948927
Name:GIL GUEVARA, ANDREA DEL VALLE (MD)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:DEL VALLE
Last Name:GIL GUEVARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:1650 SKYLYN DR STE 200
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-1069
Practice Address - Country:US
Practice Address - Phone:645-604-5008
Practice Address - Fax:864-560-4540
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100639092084N0400X
SC905742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology