Provider Demographics
NPI:1588846562
Name:GABLE, NICOLE JEAN (MD, FAAP)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:JEAN
Last Name:GABLE
Suffix:
Gender:F
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:NICOEL
Other - Middle Name:JEAN
Other - Last Name:SCHUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10755 FALLS ROAD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4515
Mailing Address - Country:US
Mailing Address - Phone:410-583-2955
Mailing Address - Fax:410-583-2962
Practice Address - Street 1:10755 FALLS ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4515
Practice Address - Country:US
Practice Address - Phone:410-583-2955
Practice Address - Fax:410-583-2962
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAJ4147357204897208000000X
MDD0067078208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics