Provider Demographics
NPI:1649390923
Name:DEL CORRAL, GABRIEL ALFONSO (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:ALFONSO
Last Name:DEL CORRAL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:193 STONER AVE
Mailing Address - Street 2:SUITE 220
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5587
Mailing Address - Country:US
Mailing Address - Phone:410-751-5606
Mailing Address - Fax:410-751-5603
Practice Address - Street 1:193 STONER AVE
Practice Address - Street 2:SUITE 220
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5587
Practice Address - Country:US
Practice Address - Phone:410-751-5606
Practice Address - Fax:410-751-5603
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2015-08-04
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Provider Licenses
StateLicense IDTaxonomies
MDD00756252086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD296031YBDBMedicare PIN