Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 0101036382 | VA |
Y | 2080P0216X | Pediatric Rheumatologist | 0101036382 | VA |
NPI | 1447200043 |
---|---|
Provider Name | Christos A. Gabriel |
First Address | Baltimore, MD 21279-0137 |
Second Address | Norfolk, VA 23507-1910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 09/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000816601 | (05) | DE |
0016609640001 | (05) | PA |
006722148 | (05) | VA |
0219980000 | (05) | WV |
130971400 | (05) | MD |
890559A | (05) | NC |
F27595 | (02) |