Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 056834 | GA |
NPI | 1376567339 |
---|---|
Provider Name | Sheryl Gabram |
First Address | Atlanta, GA 30322-1013 |
Second Address | Atlanta, GA 30322-1013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1120221 | US HEALTHCARE (01) | GA |
1771440 | UNITED HEALTHCARE (01) | GA |
850383 | BCBS (01) | GA |
E42170001 | (02) | GA |
P00289241 | RAILROAD MEDICARE (01) | GA |
Y 19990601 | PHCS (01) | GA |