Healthcare Provider Details

I. General information

NPI: 1144238726
Provider Name (Legal Business Name): STUART G. GILBERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 06/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SPRUCE LN
FALMOUTH ME
04105-1196
US

IV. Provider business mailing address

1 SPRUCE LN
FALMOUTH ME
04105-1196
US

V. Phone/Fax

Practice location:
  • Phone: 207-781-5192
  • Fax:
Mailing address:
  • Phone: 207-781-5192
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number008245
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code2085R0203X
TaxonomyTherapeutic Radiology Physician
License Number008245
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: