Werder, Gabriel Mark
Werder, Gabriel Mark is an sole proprietor health care provider with primary practice located at 1223 Gateway Dr , Melbourne FL 32901-2607. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Werder, Gabriel Mark can be contacted via phone (321) 549-0677.Contact Information
Primary practice address
1223 Gateway Dr
Melbourne FL 32901-2607
Phone: (321) 549-0677
Fax: (321) 722-2432
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 24855 | West Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 0101253202 | Virginia |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 24855 | West Virginia |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 0101253202 | Virginia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME126311 | Florida |
Profile Details
| NPI number | 1336353978 |
|---|---|
| LBN Legal business name | Werder, Gabriel Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 10th, 2007 |
| Last updated | Aug 4th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336353978 | NPPES |
| Virginia | Other | 9545845 | AETNA HEALTHCARE |
| Virginia | Other | 10106888 | AETNA HEALTHCARE |
| Virginia | Other | 10103500 | AETNA HEALTHCARE |
| Virginia | MEDICAID | 101327600 | AETNA HEALTHCARE |
| Virginia | Other | LQ097 | AETNA HEALTHCARE |
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