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Individual

LELAND T GILMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
8101 HINSON FARM RD STE 301, ALEXANDRIA, VA 22306-3405
(703) 560-3773
(703) 799-0050
Mailing address
8101 HINSON FARM RD STE 301, ALEXANDRIA, VA 22306-3405
(703) 560-3773
(703) 799-0050

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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