Healthcare Provider Details

I. General information

NPI: 1477636116
Provider Name (Legal Business Name): GABER Y YACOUB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 KIRKWOOD HWY
WILMINGTON DE
19805-4917
US

IV. Provider business mailing address

1601 KIRKWOOD HWY
WILMINGTON DE
19805-4917
US

V. Phone/Fax

Practice location:
  • Phone: 302-994-2511
  • Fax: 302-545-0928
Mailing address:
  • Phone: 302-994-2511
  • Fax: 302-545-0928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC1-0006410
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: