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General NPI Number Information
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NPI Number | 1083425870
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Entity Type | Organization
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Legal Business Name | GABRIEL U NAZARENO
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Dates
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Enumeration Date | 01/20/2025
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Last Update Date | 01/20/2025
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Provider Practice Location Address
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Address Line | 4465 NARROW LANE RD
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City | MONTGOMERY
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State | AL
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Zip | 36116-2953
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Country | US
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Telephone | 334-284-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 9743 IVY GREEN DR
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City | MONTGOMERY
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State | AL
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Zip | 36117-5152
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GABRIEL NAZARENO
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Credential | MD
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Telephone | 334-201-8168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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