MEDICARE: MRS. GABRIELLE WACHTER

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	174400000X	Specialist	7166-88	MD
2	390200000X	Student in an Organized Health Care Education/Training Program		MD
3	374J00000X	Doula	3573-16	MD

General Provider Information

NPI Number	:	1306705355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GABRIELLE WACHTER

Provider Business Mailing Address
First Line	:	6615 TUSCARORA DR
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-2811
Country	:	US
Telephone Number	:	240-626-4040
Fax Number	:

Provider Business Practice Location Address
First Line	:	6615 TUSCARORA DR
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21702-2811
Country	:	US
Telephone Number	:	240-626-4040
Fax Number	:

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

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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