Healthcare Provider Details

I. General information

NPI: 1093864407
Provider Name (Legal Business Name): ELIZABETH V GABIANA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CENTER ST SUITE 201
COLUMBUS GA
31901-1546
US

IV. Provider business mailing address

700 CENTER ST SUITE 201
COLUMBUS GA
31901-1546
US

V. Phone/Fax

Practice location:
  • Phone: 706-323-4747
  • Fax:
Mailing address:
  • Phone: 706-323-4747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number29646
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: