Provider Demographics
NPI:1700318714
Name:GIMISSO, ABEL HELEBO (MD)
Entity Type:Individual
Prefix:
First Name:ABEL
Middle Name:HELEBO
Last Name:GIMISSO
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 1:10237 GREEN HOLLY TER
Mailing Address - Street 2:SILVER SPRING, MD, 20902
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-5820
Mailing Address - Country:US
Mailing Address - Phone:202-361-4918
Mailing Address - Fax:
Practice Address - Street 1:1005 DR. D.B. TODD JR. BLVD.
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37208
Practice Address - Country:US
Practice Address - Phone:615-327-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program