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General NPI Number Information
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NPI Number | 1376568634
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Entity Type | Individual
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Provider Name | LEWIS D. GILBERT D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 807 BROAD ST
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City | SUMMERSVILLE
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State | WV
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Zip | 26651-1706
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Country | US
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Telephone | 304-872-0300
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Fax | 304-872-5999
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Provider Business Mailing Address
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Address Line | PO BOX 1008
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City | SUMMERSVILLE
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State | WV
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Zip | 26651-0048
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Country | US
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Telephone | 304-872-0300
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Fax | 304-872-5999
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2262
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 068
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License Number State | WV
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