Healthcare Provider Details

I. General information

NPI: 1386830776
Provider Name (Legal Business Name): GABRIEL E OBOITE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2007
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7525 GREENWAY CENTER DRIVE SUITE 204
GREENBELT MD
20770-3525
US

IV. Provider business mailing address

7525 GREENWAY CENTER DR STE 204
GREENBELT MD
20770-3525
US

V. Phone/Fax

Practice location:
  • Phone: 240-542-4810
  • Fax: 240-254-3558
Mailing address:
  • Phone: 240-542-4810
  • Fax: 240-254-3558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH2893
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11998
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD036361
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0068121
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberD0068121
License Number StateMD
# 6
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD036361
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: