Provider Demographics
NPI:1730288424
Name:GABRIEL, SABRY A (MD)
Entity Type:Individual
Prefix:
First Name:SABRY
Middle Name:A
Last Name:GABRIEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 GATEWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210
Mailing Address - Country:US
Mailing Address - Phone:478-210-1670
Mailing Address - Fax:478-633-8698
Practice Address - Street 1:101 GATEWAY DRIVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210
Practice Address - Country:US
Practice Address - Phone:478-210-1670
Practice Address - Fax:478-210-5813
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA036056207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000525302EMedicaid
GA08BDGVGMedicare PIN
GA080057648OtherRAILROAD MEDICARE
F44434Medicare UPIN
GA000525302RMedicaid
GA08BDGVGMedicare ID - Type Unspecified