MEDICARE: CHRISTOPHER JAMES GILBERT

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	1710I1003X	Independent Duty Medical Technicians

General Provider Information

NPI Number	:	1851627939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JAMES GILBERT

Provider Business Mailing Address
First Line	:	2504 S CHICAGO ST
Second Line	:
City	:	FAIRCHILD AFB
State	:	WA
Zip	:	99011-8548
Country	:	US
Telephone Number	:	202-251-4381
Fax Number	:

Provider Business Practice Location Address
First Line	:	PSC 1 BOX 2367
Second Line	:
City	:	APO
State	:	AE
Zip	:	09009-0024
Country	:	US
Telephone Number	:	202-251-4381
Fax Number	:

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

Provider Enumeration Date	:	10/26/2009
Last Update Date	:	01/31/2013

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