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General NPI Number Information
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NPI Number | 1063577765
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Entity Type | Organization
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Legal Business Name | S A GABRIEL DO INC
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Dates
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Enumeration Date | 12/25/2006
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 8701 OLD TROY PIKE
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City | DAYTON
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State | OH
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Zip | 45424-1066
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Country | US
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Telephone | 937-278-8244
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Fax | 937-274-8982
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Provider Business Mailing Address
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Address Line | 1501 N MAIN ST
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City | DAYTON
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State | OH
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Zip | 45405-4139
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Country | US
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Telephone | 937-278-8244
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Fax | 937-274-8982
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Authorized Official
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Title or Position | PRESIDENT OF CORPORATION
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Name | DR. ANDREW H GABRIEL
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Credential | D.O.
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Telephone | 937-278-8244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 34003827
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License Number State | OH
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