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Individual
DAVID GILLENWATER
Active
Individual
DAVID GILLENWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0421903
KS
207LA0401X
Addiction Medicine (Anesthesiology) Physician
0421903
KS
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
0421903
KS
207LP2900X
Pain Medicine (Anesthesiology) Physician
0421903
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045282
BCBS
KS
01
—
050022332
RAILROAD MEDICARE
—
05
—
100142910A
—
KS
01
—
481129529
TRICARE
—
Enumeration date
03/08/2006
Last updated
06/03/2008
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