MEDICARE: TIMOTHY DAVID GILBERT DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	36001815G	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548207632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY DAVID GILBERT DPM

Provider Business Mailing Address
First Line	:	3054 PLEASANT HILL RD
Second Line	:
City	:	MAUMEE
State	:	OH
Zip	:	43537-9635
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3054 PLEASANT HILL RD
Second Line	:
City	:	MAUMEE
State	:	OH
Zip	:	43537-9635
Country	:	US
Telephone Number	:	419-861-9595
Fax Number	:	419-861-9696

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	06/22/2012

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