NPI Code Detail JSON Logo

1053336206 NPI number — MICHAEL GILMORE DO

NPI Number: 1053336206
Health Care Provider/Practitioner: MICHAEL GILMORE DO

Information about “1053336206” NPI (MICHAEL GILMORE DO) exists in 1053336206 in HTML format HTML  |  1053336206 in plain Text format TXT  |  1053336206 in PDF (Portable Document Format) PDF  |  1053336206 in an XML format XML  formats.

NPI Number : 1053336206 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053336206",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GILMORE",
    "FirstName": "MICHAEL",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "DO",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "PO BOX 1328",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "AUBURN",
    "MailingAddressStateName": "ME",
    "MailingAddressPostalCode": "04211-1328",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "207-784-9185",
    "MailingAddressFaxNumber": "207-784-1594",
    "FirstLinePracticeLocationAddress": "824 STILLWATER AVE",
    "SecondLinePracticeLocationAddress": "STE B",
    "PracticeLocationAddressCityName": "BANGOR",
    "PracticeLocationAddressStateName": "ME",
    "PracticeLocationAddressPostalCode": "04401-3614",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "207-941-0080",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/12/2006",
    "LastUpdateDate": "04/19/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "1808",
        "LicenseNumberStateCode": "ME",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.