Healthcare Provider Details

I. General information

NPI: 1770232324
Provider Name (Legal Business Name): GISELLA A. MANCARELLA WARD MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 GORDON SMITH DR
MOBILE AL
36617-2318
US

IV. Provider business mailing address

PO BOX 35752
BELFAST ME
04915-0635
US

V. Phone/Fax

Practice location:
  • Phone: 251-434-3475
  • Fax: 251-434-3837
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.47888
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberL.5800R
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: