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Organization
DAVID GANNON, DPM, LLC
Active
Organization
DAVID GANNON, DPM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GANNON DPM (DOCTOR/OWNER)
(410) 629-0222
Entity
Organization
Contact information
Practice address
96 ATLANTIC AVE, UNIT #3, OCEAN VIEW, DE 19970-9103
(410) 629-0222
(410) 629-0225
Mailing address
9956 N MAIN ST, SUITE #5, BERLIN, MD 21811-1077
(410) 629-0222
(410) 629-0225
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E1-0000205
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861415200
—
DE
01
—
E1-0000205
DELAWARE LICENSE
DE
Enumeration date
08/02/2013
Last updated
08/02/2013
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