Healthcare Provider Details

I. General information

NPI: 1558704106
Provider Name (Legal Business Name): MICHAEL GABRIEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2013
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PEARL ST FL 14
HARTFORD CT
06103-4500
US

IV. Provider business mailing address

333 COMMERCE ST STE 700
NASHVILLE TN
37201-1835
US

V. Phone/Fax

Practice location:
  • Phone: 888-355-3902
  • Fax:
Mailing address:
  • Phone: 615-454-9850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number25MA10449300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number042.0015733
License Number StateVT
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number294552
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number35C.000752
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number22248
License Number StateNH
# 6
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD25140
License Number StateME
# 7
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberMD17236
License Number StateRI
# 8
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number286653
License Number StateMA
# 9
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number55808
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: