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Individual

LELAND T GILMORE

Active
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Individual

LELAND T GILMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000826
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009302867
—
VA
05
—
010837200
—
DC
01
—
105546001
DME SUPPLIER
VA
01
—
1699963157
GROUP NPI
VA
01
—
290062
ANTHEM
VA
01
—
480008618
RAILROAD MEDICRE
VA
01
—
A729 0001
CAREFIRST/BCBS
VA
Enumeration date
06/28/2005
Last updated
01/25/2019
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