Basic Information
| Provider Information | |||||||||
| NPI: | 1730288424 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GABRIEL | ||||||||
| FirstName: | SABRY | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5437 BOWMAN RD | ||||||||
| Address2: | STE 126 | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312106574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4786338682 | ||||||||
| FaxNumber: | 4786338698 | ||||||||
| Practice Location | |||||||||
| Address1: | 770 PINE ST | ||||||||
| Address2: | STE 140 | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312012173 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4786338682 | ||||||||
| FaxNumber: | 4786338698 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 01/31/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036056 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.