Individual
JOHN A. GILLESPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9733 HEALTHWAY DR, BERLIN, MD 21811-1155
(410) 641-9109
(410) 629-1203
Mailing address
10026 OLD OCEAN CITY BLVD, BUILDING ONE, BERLIN, MD 21811-1288
(410) 641-9109
(410) 629-1203
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0063904
MD
208M00000X
Hospitalist Physician
D0063904
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000038891
—
DE
05
—
409649500
—
MD
Enumeration date
11/07/2005
Last updated
04/18/2012
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