institution
David Gannon Dpm Llc
Foot & Ankle Surgery Podiatrist in Berlin, Maryland
NPI 1861415200

David Gannon Dpm Llc is a Foot & Ankle Surgery Podiatrist based in Berlin, MD and is specialized in Foot & Ankle Surgery. David Gannon Dpm Llc practices in Berlin, MD. The NPI Number for David Gannon Dpm Llc is 1861415200 and holds a License No. 01311 (Maryland).

The current practice location address for David Gannon Dpm Llc is 9956 N Main St, Berlin, MD and can be reached out via phone at 410-629-0222 and via fax at 410-629-0225.

Location: 9956 N Main St, Berlin, MD, 21811-1077
institution
Provider Profile Details
NPI Number
1861415200
Provider Name
David Gannon Dpm Llc
Credential
Provider Entity Type
Organization
Address
9956 N Main St, Berlin, MD, 21811-1077
Phone Number
410-629-0222
Fax Number
410-629-0225
Provider Enumeration Date
07/26/2006
Last Update Date
03/08/2024
tick
Provider's Legacy Identifiers
Identifier Type State Issuer
4150953-00 05 MD
DN7994 01 MD RAIL ROAD MEDICARE GROUP PTAN
6031730001 01 DME
institution
Provider Business Practice Location Address Details
Address
9956 N Main St
City
State
Zip
21811-1077
Phone Number
410-629-0222
Fax Number
410-629-0225
person
Provider Business Mailing Address Details
Address
9956 N Main St
City
State
Zip
21811-1077
Phone Number
410-629-0222
Fax Number
410-629-0225
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
01311 (Maryland)
Definition
Definition to come...
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