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General NPI Number Information
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NPI Number | 1811977465
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Entity Type | Individual
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Provider Name | GABE MIRKIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 10901 CONNECTICUT AVENUE
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City | KENSINGTON
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State | MD
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Zip | 20895-1645
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Country | US
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Telephone | 301-942-7900
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Fax | 301-942-9837
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Provider Business Mailing Address
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Address Line | 1455 BRIER CREEK CIR
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City | THE VILLAGES
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State | FL
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Zip | 32162-4101
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Country | US
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Telephone | 352-350-6216
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Fax | 352-350-6216
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0013921
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License Number State | MD
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