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Individual
GAYLE FAYE SACRY
Active
Individual
GAYLE FAYE SACRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3623
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005622
—
ID
05
—
0068744
—
MT
01
—
07160
BCBS MT PROV ID
MT
01
—
138829
WA WORK COMP
WA
01
—
184739200
FED WORK COMP GROUP ID
—
01
—
3623
MT LICENSE
MT
Enumeration date
09/20/2005
Last updated
03/07/2023
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