Healthcare Provider Details

I. General information

NPI: 1508095910
Provider Name (Legal Business Name): JAMES T GILSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NATIONAL NAVAL MEDICAL CTR 8901 WISCONSIN AVE
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

NATIONAL NAVAL MEDICAL CTR 8901 WISCONSIN AVE
BETHESDA MD
20889-5600
US

V. Phone/Fax

Practice location:
  • Phone: 301-296-0196
  • Fax:
Mailing address:
  • Phone: 301-296-0196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number0101248695
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101248695
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: