Healthcare Provider Details

I. General information

NPI: 1558422758
Provider Name (Legal Business Name): WILLIAM DAVID GIFT DC, DABFP, DABCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 OPAL CT
HAGERSTOWN MD
21740-5940
US

IV. Provider business mailing address

1120 OPAL CT
HAGERSTOWN MD
21740-5940
US

V. Phone/Fax

Practice location:
  • Phone: 301-739-4878
  • Fax: 301-739-4989
Mailing address:
  • Phone: 301-739-4878
  • Fax: 301-739-4989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberSO1445PT
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC003877L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: