Provider Demographics
NPI:1942173521
Name:GABLE, AUSTIN SCOTT (CCG)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:SCOTT
Last Name:GABLE
Suffix:
Gender:M
Credentials:CCG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N BROADWAY RM 564
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1424
Mailing Address - Country:US
Mailing Address - Phone:443-923-9543
Mailing Address - Fax:
Practice Address - Street 1:801 N BROADWAY RM 564
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21205-1424
Practice Address - Country:US
Practice Address - Phone:443-923-9543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDG0000490170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS