Provider Demographics
NPI:1043418858
Name:CENTERS, GABRIELA IRINA (MD)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:IRINA
Last Name:CENTERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GABRIELA
Other - Middle Name:IRINA
Other - Last Name:BOTEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1026
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-1026
Mailing Address - Country:US
Mailing Address - Phone:317-274-1201
Mailing Address - Fax:317-278-9905
Practice Address - Street 1:7777 FOREST LN STE C300J
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2604
Practice Address - Country:US
Practice Address - Phone:972-401-9807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01074099207LC0200X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201235670Medicaid
IN145590070Medicare PIN