MEDICARE: DR. SHARI ROSENBERG GABRIEL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	31883	KY
2	207XP3100X	Pediatric Orthopaedic Surgery Physician	31883	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000185962	OTHER	KY	BLUE PREFERRED (ANTHEM)
2	1129536	OTHER	KY	PASSPORT
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033112354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARI ROSENBERG GABRIEL M.D.

Provider Business Mailing Address
First Line	:	6400 DUTCHMANS PKWY
Second Line	:	STE 215
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3343
Country	:	US
Telephone Number	:	502-721-8288
Fax Number	:	502-721-8792

Provider Business Practice Location Address
First Line	:	6400 DUTCHMANS PKWY
Second Line	:	STE 215
City	:	LOUISVILLE
State	:	KY
Zip	:	40205-3343
Country	:	US
Telephone Number	:	502-721-8288
Fax Number	:	502-721-8792

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	12/08/2023

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