Provider Demographics
NPI:1538173760
Name:PUSHKAS, GABRIEL PETER (MD)
Entity type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:PETER
Last Name:PUSHKAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1012 SANDPIPER LN
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-4633
Mailing Address - Country:US
Mailing Address - Phone:301-881-3940
Mailing Address - Fax:301-230-2635
Practice Address - Street 1:1012 SANDPIPER LN
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-4633
Practice Address - Country:US
Practice Address - Phone:301-881-3940
Practice Address - Fax:301-230-2635
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD21531207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCB94137Medicare UPIN
DC174752P74Medicare PIN