Healthcare Provider Details

I. General information

NPI: 1568619914
Provider Name (Legal Business Name): DR. WILLIAM D. GIFT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 08/27/2008
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 TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC003877L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberSO1445PT
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License NumberDC003877L
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberSO1445PT
License Number StateMD

VIII. Authorized Official

Name: DR. WILLIAM DAVID GIFT
Title or Position: PRESIDENT
Credential: DC, DABFP, DABCC.
Phone: 301-739-4878