Provider Demographics
NPI:1700346780
Name:GAZZETTA, ERIKA ROSE (MD)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:ROSE
Last Name:GAZZETTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ERIKA
Other - Middle Name:ROSE
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:777 LOWNDES HILL RD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2101
Mailing Address - Country:US
Mailing Address - Phone:614-352-5094
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-8500
Practice Address - Country:US
Practice Address - Phone:614-352-5094
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023044657207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology