Individual
DAMON L GATEWOOD
Active
Individual
DAMON L GATEWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
37028
KY
207R00000X
Internal Medicine Physician
Primary
37028
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225634
ANTHEM
KY
01
—
1165569
PASSPORT
KY
01
—
2439968000
PASSPORT ADVANTAGE
KY
05
—
64051949
—
KY
Enumeration date
03/07/2006
Last updated
08/18/2017
Update your record
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