Provider Demographics
NPI:1972618874
Name:NATELLO, GREGORY W (DO)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:W
Last Name:NATELLO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 BEAVER CRST
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-2662
Mailing Address - Country:US
Mailing Address - Phone:800-000-1212
Mailing Address - Fax:
Practice Address - Street 1:221 BEAVER CRST
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2662
Practice Address - Country:US
Practice Address - Phone:800-000-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO 143207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC78708Medicare UPIN