Individual
GAIL SHAW MARGERUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 PRUDENTIAL DR, JACKSONVILLE, FL 32207-8202
(904) 202-2046
Mailing address
820 PRUDENTIAL DR STE 713, JACKSONVILLE, FL 32207-8209
(904) 396-5682
(904) 346-0864
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101056391
VA
207P00000X
Emergency Medicine Physician
31576
NC
207P00000X
Emergency Medicine Physician
Primary
ME98283
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187611637A
—
GA
01
—
23923
BCBS
FL
05
—
27791110
—
FL
Enumeration date
05/16/2006
Last updated
05/17/2021
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