Basic Information
Provider Information
NPI: 1003005174
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GILMAN
FirstName: DAVID
MiddleName: M.
NamePrefix: MR.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3421 CONCORD RD
Address2:  
City: YORK
State: PA
PostalCode: 174029001
CountryCode: US
TelephoneNumber: 7178511405
FaxNumber: 7178516969
Practice Location
Address1: 300 PINE GROVE CMNS
Address2:  
City: YORK
State: PA
PostalCode: 17403
CountryCode: US
TelephoneNumber: 7178516110
FaxNumber: 7177411076
Other Information
ProviderEnumerationDate: 10/15/2007
LastUpdateDate: 05/01/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA057342PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 
363A00000X2386MAN Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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