Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | TA0882 | MD |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | TA0882 | MD |
NPI | 1184956492 |
---|---|
Provider Name | David Samuel Gamerman |
First Address | Reisterstown, MD 21136-5542 |
Second Address | Reisterstown, MD 21136-5542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2010 |
Last Update Date | 11/02/2010 |