Healthcare Provider Details

I. General information

NPI: 1447250758
Provider Name (Legal Business Name): GREGORY LOUIS VRABEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 01/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 W MAIN ST
NEWARK OH
43055-1822
US

IV. Provider business mailing address

1320 W MAIN ST
NEWARK OH
43055-1822
US

V. Phone/Fax

Practice location:
  • Phone: 740-348-4318
  • Fax: 740-348-4217
Mailing address:
  • Phone: 740-348-4318
  • Fax: 740-348-4217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35070209
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: