Provider Demographics
NPI:1427115856
Name:GABOR, QUENTIN MARTIN (MD)
Entity type:Individual
Prefix:DR
First Name:QUENTIN
Middle Name:MARTIN
Last Name:GABOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1919 UNIVERSITY AVE W STE 200
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-3435
Mailing Address - Country:US
Mailing Address - Phone:651-266-7999
Mailing Address - Fax:651-266-7851
Practice Address - Street 1:1919 UNIVERSITY AVE W STE 200
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3435
Practice Address - Country:US
Practice Address - Phone:651-266-7999
Practice Address - Fax:651-266-7851
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN483622084P0800X
WI44748-0202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN360362800Medicaid
MN360362800Medicaid