Provider Demographics
NPI:1255368916
Name:GELLMAN, MICHAEL LOUIS (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LOUIS
Last Name:GELLMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1401 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3023
Mailing Address - Country:US
Mailing Address - Phone:404-475-0386
Mailing Address - Fax:404-475-0443
Practice Address - Street 1:1401 PEACHTREE ST NE
Practice Address - Street 2:SUITE 160
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3023
Practice Address - Country:US
Practice Address - Phone:404-475-0386
Practice Address - Fax:404-475-0443
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR005228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
35ZCGNPMedicare PIN