Provider Demographics
NPI:1245490135
Name:SPRING, GABRIEL B (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:B
Last Name:SPRING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:455 S MAPLE AVE APT 401
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4278
Mailing Address - Country:US
Mailing Address - Phone:540-871-4499
Mailing Address - Fax:
Practice Address - Street 1:8201 CORPORATE DR STE 650
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2371
Practice Address - Country:US
Practice Address - Phone:504-321-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306222207Q00000X
MDD0082078207Q00000X
DCMD047695207Q00000X
VA0101248472207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD121657100Medicaid
DC043095755Medicaid
MD121657101Medicaid
MD121657102Medicaid