Individual
DAVID GUSSOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33 FREDERICK ST, HANOVER, PA 17331-3502
(717) 632-4900
(717) 637-2611
Mailing address
625 W ELM AVE, HANOVER, PA 17331-5125
(717) 632-4900
(717) 632-4313
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD067026L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009361860001
—
PA
Enumeration date
12/18/2006
Last updated
08/26/2011
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