Healthcare Provider Details

I. General information

NPI: 1952960734
Provider Name (Legal Business Name): GABRIEL MARTIN PAJARES HURTADO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2019
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 COLLIER RD NW STE 500
ATLANTA GA
30309-1711
US

IV. Provider business mailing address

330 BROOKLINE AVE
BOSTON MA
02215-5400
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-2800
  • Fax:
Mailing address:
  • Phone: 617-667-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number290514
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number110356
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: