Provider Demographics
NPI:1952552945
Name:CUMBERBATCH, GREGORY ALVIN (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ALVIN
Last Name:CUMBERBATCH
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:805 SANDY PLAINS ROAD
Mailing Address - Street 2:MEDICAL STAFF SERVICES
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-6340
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:285 BOULEVARD NE
Practice Address - Street 2:SUITE 415
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-4205
Practice Address - Country:US
Practice Address - Phone:404-265-4400
Practice Address - Fax:404-265-4452
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2023-02-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA066772207T00000X
FLME117465207T00000X
VA0101254795207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery