Provider Demographics
NPI:1588762272
Name:GILBERT, RICHARD ALCIDE (DO)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:ALCIDE
Last Name:GILBERT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29955 THREE NOTCH RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:20622-3159
Mailing Address - Country:US
Mailing Address - Phone:301-290-5300
Mailing Address - Fax:301-290-5301
Practice Address - Street 1:29955 THREE NOTCH RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE HALL
Practice Address - State:MD
Practice Address - Zip Code:20622-3159
Practice Address - Country:US
Practice Address - Phone:301-290-5300
Practice Address - Fax:301-290-5301
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS009886L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG89087Medicare UPIN
PA025508Medicare ID - Type UnspecifiedMEDICARE