Healthcare Provider Details

I. General information

NPI: 1760366173
Provider Name (Legal Business Name): DR. WILLIAM GAMBLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7165 COLUMBIA GATEWAY DR STE A
COLUMBIA MD
21046-2145
US

IV. Provider business mailing address

7411 RICKSWAY RD
PIKESVILLE MD
21208-5720
US

V. Phone/Fax

Practice location:
  • Phone: 443-441-0616
  • Fax:
Mailing address:
  • Phone: 617-939-6456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: