Individual
DR. DAVID A GILMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
510 S 4TH ST, FULTON, NY 13069-2904
(315) 555-5555
Mailing address
510 S 4TH ST, FULTON, NY 13069-2904
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
001033
NY
207QA0505X
Adult Medicine Physician
Primary
A204316
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000918142003
HEALTHNOW NY
NY
05
—
02379335
—
NY
01
—
204316-4 W
WORKER'S COMPENSATION
NY
01
—
5903572
GHI PPO
NY
Enumeration date
11/01/2006
Last updated
07/31/2019
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