Basic Information
| Provider Information | |||||||||
| NPI: | 1801054754 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GATES | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | GILCHRIST | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7987 | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366700987 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516330573 | ||||||||
| FaxNumber: | 2516337367 | ||||||||
| Practice Location | |||||||||
| Address1: | 5955 AIRPORT BLVD | ||||||||
| Address2: | |||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516330573 | ||||||||
| FaxNumber: | 2516337367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2008 | ||||||||
| LastUpdateDate: | 06/28/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 29903 | AL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207K00000X | 29903 | AL | Y | Allopathic & Osteopathic Physicians | Allergy & Immunology |
ID Information
| ID | Type | State | Issuer | Description | 151374 | 05 | AL | MEDICAID | 511-95657 | 01 | AL | BCBS | OTHER | 4721316 | 01 | AL | AETNA | OTHER | 02252774 | 01 | AL | MS MEDICAID | OTHER | 222452 | 05 | AL | MEDICAID | 2701894 | 01 | AL | CIGNA HC | OTHER | 213037 | 05 | AL | MEDICAID | 511-37042 | 01 | AL | BCBS | OTHER | 102I031769 | 01 | AL | MEDICARE | OTHER | 214406 | 05 | AL | MEDICAID | 3617780 | 01 | AL | UHC | OTHER | P01226145 | 01 | AL | RR MEDICARE | OTHER | Z96092 | 01 | AL | VIVA HEALTH | OTHER | 511-37043 | 01 | AL | BCBS | OTHER | 511-37044 | 01 | AL | BCBS | OTHER |