Provider Demographics
NPI:1336110410
Name:GABEL, DOROTEA M (MD)
Entity Type:Individual
Prefix:DR
First Name:DOROTEA
Middle Name:M
Last Name:GABEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:100 E WOOD ST
Practice Address - Street 2:STE. 401
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3004
Practice Address - Country:US
Practice Address - Phone:864-560-6851
Practice Address - Fax:864-560-7312
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23191207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7749394OtherAETNA
NC89066P4Medicaid
SC231911Medicaid
SCC8689OtherMEDCOST
SCH669533365Medicare PIN
SCP00040882Medicare PIN
SCC8689OtherMEDCOST
SCH66953Medicare UPIN
SCP00282758Medicare PIN