Organization
BRIAN L GATES DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN L GATES DPM (PRESIDENT)
(814) 943-9885
Entity
Organization
Contact information
Practice address
521 LOGAN BOULEVARD LAKEMONT, ALTOONA, PA 16602-5619
(814) 943-9885
(814) 943-5492
Mailing address
521 LOGAN BOULEVARD LAKEMONT, ALTOONA, PA 16602-5619
(814) 943-9885
(814) 943-5492
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002225L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
084466
MEDICARE PROVIDER ID#
PA
Enumeration date
12/01/2006
Last updated
11/09/2007
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