Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | MD00033964 | WA |
NPI | 1013012459 |
---|---|
Provider Name | Dr. Stanley Craig Gilbert |
First Address | Bellingham, WA 98225 |
Second Address | Bellingham, WA 98225-2076 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 23/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1110139 | (05) | WA |
D16930 | (02) |