Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | D0040704 | MD |
N | 2081P2900X | Pain Medicine | D0040704 | MD |
NPI | 1063428233 |
---|---|
Provider Name | Jeffrey Gambel |
First Address | Columbia, MD 21044-1102 |
Second Address | Halethorpe, MD 21227-3553 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/01/2022 |