Provider Demographics
NPI:1942644281
Name:SAKELLARIDES, GABRIELLE D (DO)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:D
Last Name:SAKELLARIDES
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 MASON DIXON HWY
Mailing Address - Street 2:
Mailing Address - City:MAIDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26541-8152
Mailing Address - Country:US
Mailing Address - Phone:304-879-5020
Mailing Address - Fax:304-879-4105
Practice Address - Street 1:1929 MASON DIXON HWY
Practice Address - Street 2:
Practice Address - City:MAIDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26541-8152
Practice Address - Country:US
Practice Address - Phone:304-879-5020
Practice Address - Fax:304-879-4105
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2909207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine