Healthcare Provider Details

I. General information

NPI: 1013613355
Provider Name (Legal Business Name): CLAIRE GILMORE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 02/07/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9813 MONTAUK AVE
BETHESDA MD
20817-1623
US

IV. Provider business mailing address

9813 MONTAUK AVE
BETHESDA MD
20817-1623
US

V. Phone/Fax

Practice location:
  • Phone: 301-906-3012
  • Fax:
Mailing address:
  • Phone: 301-906-3012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number18801
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: