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Individual
DANIEL MACK GABRIELSON
Active
Individual
DANIEL MACK GABRIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
3611
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0283465
—
IA
05
—
0293522
—
IA
05
—
0424507
—
IA
05
—
0600460
—
IA
05
—
0635011
—
IA
05
—
0655001
—
IA
01
—
29352
BCBS ER
IA
01
—
33444
FPC BCBS NRH
IA
01
—
36174
BCBS DME
IA
01
—
60046
BCBS REG
IA
01
—
66046
BCBS SNF
IA
Enumeration date
06/08/2006
Last updated
04/14/2020
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