Basic Information
| Provider Information | |||||||||
| NPI: | 1427024496 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILBERT | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 310 STOCK ST | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173312276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176371738 | ||||||||
| FaxNumber: | 7176373044 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 STOCK ST | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | HANOVER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 173312276 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7176371738 | ||||||||
| FaxNumber: | 7176373044 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/28/2006 | ||||||||
| LastUpdateDate: | 12/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | OS010331L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | OS010331L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | 207RI0011X | OS010331L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 0018403450004 | 05 | PA | MEDICAID | 0018403450003 | 05 | PA | MEDICAID |