1568619914 NPI number — DR. WILLIAM D. GIFT, PC

Table of content: (NPI 1568619914)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568619914 NPI number — DR. WILLIAM D. GIFT, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR. WILLIAM D. GIFT, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568619914
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1120 OPAL CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAGERSTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21740-5940
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-739-4878
Provider Business Mailing Address Fax Number:
301-739-4989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1120 OPAL CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21740-5940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-739-4878
Provider Business Practice Location Address Fax Number:
301-739-4989
Provider Enumeration Date:
08/27/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GIFT
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-739-4878

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  SO1445PT , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: DC003877L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111NI0013X , with the licence number: SO1445PT , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111NI0013X , with the licence number: DC003877L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2013908 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 320534 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: GI601533 . This is a "BLUE SHIELD OF PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 350050504 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 3607 . This is a "BLUE SHIELD OF DC" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 4400181 . This is a "UNITED" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 459700100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 77KCWD . This is a "BLUE SHIELD OF MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 287 . This is a "MEDICARE STATE OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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