Provider Demographics
NPI:1568445138
Name:GEHLOT, ROSY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSY
Middle Name:
Last Name:GEHLOT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROSY
Other - Middle Name:
Other - Last Name:AHLUWALIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 72103
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-2103
Mailing Address - Country:US
Mailing Address - Phone:229-435-2502
Mailing Address - Fax:
Practice Address - Street 1:1905 PALMYRA RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1574
Practice Address - Country:US
Practice Address - Phone:229-435-2502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055225208000000X
DEC1-0005970208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H81641Medicare UPIN