Provider Demographics
NPI:1558704106
Name:GABRIEL, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 COMMERCE ST STE 700
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37201-1835
Mailing Address - Country:US
Mailing Address - Phone:615-454-9850
Mailing Address - Fax:
Practice Address - Street 1:100 PEARL ST FL 14
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-4500
Practice Address - Country:US
Practice Address - Phone:888-355-3902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA10449300207QH0002X
VT042.0015733207QH0002X
NY294552207QH0002X
OH35C.000752207QH0002X
NH22248207QH0002X
MEMD25140207QH0002X
RIMD17236207QH0002X
MA286653207QH0002X
CT55808207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine