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General NPI Number Information
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NPI Number | 1942596325
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Entity Type | Organization
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Legal Business Name | GABRIEL A BERREBI MD FACP LLC
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Dates
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Enumeration Date | 06/23/2011
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Last Update Date | 06/23/2011
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Provider Practice Location Address
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Address Line | 11904 DARNESTOWN RD STE F
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-3202
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Country | US
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Telephone | 301-926-7776
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Fax | 301-926-7077
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Provider Business Mailing Address
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Address Line | 11904 F DARNESTOWN ROAD
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-3202
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Country | US
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Telephone | 301-926-7776
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Fax | 301-926-7077
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Authorized Official
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Title or Position | PHYSICIAN
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Name | GABRIEL A BERREBI
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Credential | MD
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Telephone | 301-926-7776
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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 | D0030692
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License Number State | MD
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