Provider Demographics
NPI: | 1023182722 |
---|---|
Name: | EISNER, GILBERT MARTIN (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | GILBERT |
Middle Name: | MARTIN |
Last Name: | EISNER |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 1120 19TH STREET NW |
Mailing Address - Street 2: | SUITE 200 |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20036-3615 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-296-0670 |
Mailing Address - Fax: | 202-331-8924 |
Practice Address - Street 1: | 1120 19TH STREET NW |
Practice Address - Street 2: | SUITE 200 |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20036-3615 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-296-0670 |
Practice Address - Fax: | 202-331-8924 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-11-17 |
Last Update Date: | 2009-12-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
DC | MD2183 | 207R00000X, 207RN0300X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
000K49541 | Medicare ID - Type Unspecified | ||
B93089 | Medicare UPIN |