Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | A204316 | NY |
NPI | 1346328911 |
---|---|
Provider Name | Dr. David A Gilmore |
First Address | Fulton, NY 13069-2904 |
Second Address | Fulton, NY 13069-2904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 31/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000918142003 | HEALTHNOW NY (01) | NY |
02379335 | (05) | NY |
204316-4 W | WORKER'S COMPENSATION (01) | NY |
5903572 | GHI PPO (01) | NY |
G55706 | (02) | NY |