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NPI Code Detail

MEDICARE: JOHN GILSTAD MD

MEDICARE: JOHN GILSTAD MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0300XGeriatric Medicine (Internal Medicine) Physician47855MD

General Provider Information

NPI Number : 1669473856
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN GILSTAD MD
Provider Business Mailing Address
First Line : US NAVAL HOSPITAL
Second Line : PSC 475 BOX 1723
City : FPO
State : AP
Zip : 96350
Country : US
Telephone Number : 81468167816
Fax Number :
Provider Business Practice Location Address
First Line : US NAVAL HOSPITAL
Second Line : PSC 475 BOX 1723
City : FPO
State : AP
Zip : 96350
Country : US
Telephone Number : 81468167816
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 04/20/2008

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