MEDICARE: GORDON BRADLEY WERBEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	31154	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	020024445	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417959065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GORDON BRADLEY WERBEL M.D.

Provider Business Mailing Address
First Line	:	1800 TREE LANE RD
Second Line	:	SUITE 330
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-4700
Country	:	US
Telephone Number	:	770-978-0561
Fax Number	:	770-978-0546

Provider Business Practice Location Address
First Line	:	1800 TREE LANE RD
Second Line	:	SUITE 330
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-4700
Country	:	US
Telephone Number	:	770-978-0561
Fax Number	:	770-978-0546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	11/01/2007

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Directions to “ GORDON BRADLEY WERBEL M.D.” Practice Location

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