DR. PEDRO ARCHEVALD (NPI# 1821165176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821165176 |
| Entity Type | Individual |
| Full Name | DR. PEDRO ARCHEVALD |
| Credential | MD |
| Practice Address |
300 W Hospital Rd Fort Gordon GA 30905-5741 |
| Mailing Address |
300 W Hospital Rd Eisenhower Army Med Cen, Anesthesia Service Fort Gordon GA 30905-5741 |
| Practice Telephone | 7067871910 |
| Mailing Telephone | 7067871910 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | 108271 | MO | Other Service Providers |
| Street Address |
300 W HOSPITAL RD |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30905-5741 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922007467 | John Keenan Wilson | Internal Medicine | 300 W Hospital Rd, Building 300, Fort Gordon, GA 30905-5741 | 2005-07-18 |
| 1629687751 | Benjamin Lee Tigges | Nurse Anesthetist, Certified Registered | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-07-24 |
| 1104441179 | Gia-thien H Nguyen | Student in an Organized Health Care Education/Training Program | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-06-15 |
| 1184249765 | Roman Avila | Student in an Organized Health Care Education/Training Program | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-06-10 |
| 1417572116 | Francesco Anthony Biolzi | Student in an Organized Health Care Education/Training Program | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2020-06-09 |
| 1114568268 | Ryan Sever | Psychologist | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-09-30 |
| 1801446497 | Seth Randall | Nurse Practitioner | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-09-16 |
| 1275188179 | Jason Celestino | Nurse Anesthetist, Certified Registered | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-08-07 |
| 1467011668 | Angelina Kathleen Trush | Student in an Organized Health Care Education/Training Program | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2019-06-11 |
| 1790271989 | Joshua Orszag | Nurse Anesthetist, Certified Registered | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2018-07-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083772446 | Eric D Wessling | Military Health Care Provider | Building 300 Chamberlain Ave, Fort Gordon, GA 30905 | 2006-12-05 |
| 1982229399 | Jesse K Laverdiere | Military Health Care Provider | 300 E Hospital Rd, Fort Gordon, GA 30905 | 2020-06-11 |
| 1619136108 | Ashley Meagan Fox | Military Health Care Provider | 300 W Hospital Rd, Ddeamc - Attn: Physical Therapy, Fort Gordon, GA 30905-5741 | 2008-06-09 |
| 1689833063 | Jason Anthony Skarosi | Military Health Care Provider | 300 W Hospital Road Eisenhower Army Medical Center, Attn Credentials, Fort Gordon, GA 30905-5650 | 2008-06-02 |
| 1962678235 | Sheldon John Phillips | Military Health Care Provider | 300 W Hospital Rd, Eisenhower Army Medical Center, Attn: Credentials, Fort Gordon, GA 30905-5741 | 2008-05-06 |
| 1891849691 | Terry Lee Mueller | Military Health Care Provider | 300 W Hospital Rd, Orthopaedic Surgery Clinic, Fort Gordon, GA 30905-5741 | 2007-01-22 |
| 1003983354 | Helen Ann Santiago | Military Health Care Provider | 300 W Hospital Road, Eisenhower Army Medical Center, Fort Gordon, GA 30905-5741 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700425568 | Greggory Theotis Kent | Military Health Care Provider | 223 E Grady Ave, Lyons, GA 30436-1509 | 2019-12-26 |
| 1083142947 | Integrative Cap Health Practices | Military Health Care Provider | 770 Old Roswell Pl Ste G400, Roswell, GA 30076-8635 | 2017-05-23 |
| 1972037323 | Alicia Anderson | Military Health Care Provider | 621 Mcgruder St. Ne, Atlanta, GA 30312 | 2017-04-12 |
| 1508227141 | Compassion Community PCh LLC | Military Health Care Provider | 1942 Appling Harlem Rd, Appling, GA 30802-3723 | 2016-03-09 |
| 1982063749 | Mallori Tittle | Military Health Care Provider | 6254 Warm Springs Rd Apt G6, Columbus, GA 31909-9152 | 2016-02-22 |
| 1902243876 | Victor D Parker IIi | Military Health Care Provider | 78th Medical Group Sghc, 655 Seventh Street, Robins Afb, GA 31098 | 2013-05-31 |
| 1235575325 | Gerardo Julian Soracco | Military Health Care Provider | 4415 Northside Chase Nw, Atlanta, GA 30327-3567 | 2013-05-15 |
| 1790023406 | Donna Sue Muller | Military Health Care Provider | 2715 Cosmos Dr Ne, Atlanta, GA 30345-1307 | 2013-01-30 |
| 1316298144 | Sandra Diane Tyree | Military Health Care Provider | 6490 Clyattstone Rd, Hahira, GA 31632-3112 | 2012-09-19 |
| 1558643536 | Eleanor S. Lee | Military Health Care Provider | 4211 Misty Morning Way, #2319, Gainesville, GA 30506-4347 | 2011-09-15 |
| Find all providers with the same taxonomy | ||||
| City | FORT GORDON |
| Zip Code | 30905 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.