Healthcare Provider Details

I. General information

NPI: 1639143993
Provider Name (Legal Business Name): WILLIAM S GILBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 05/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5454 WISCONSIN AVE SUITE # 1540
CHEVY CHASE MD
20815-6901
US

IV. Provider business mailing address

3404 SHEPHERD ST
CHEVY CHASE MD
20815-3224
US

V. Phone/Fax

Practice location:
  • Phone: 301-656-8100
  • Fax: 301-652-2957
Mailing address:
  • Phone: 301-654-5558
  • Fax: 301-654-5558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD0004150
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number0101018821
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD3618
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: