Provider Demographics
NPI:1033178082
Name:GILBERT, DAVID M (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:GILBERT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1547 LASKIN RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6111
Mailing Address - Country:US
Mailing Address - Phone:757-425-0200
Mailing Address - Fax:757-428-2823
Practice Address - Street 1:1547 LASKIN RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6111
Practice Address - Country:US
Practice Address - Phone:757-425-0200
Practice Address - Fax:757-428-2823
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0601800441152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0618001302OtherOPTOMETRIST TPA#
VA386479OtherANTHEM BC/BS PROVIDER ID#
VAVA0441OtherEYEMED PROVIDER ID#
VA11323644OtherCAQH PROVIDER ID#
VA70247OtherSENTARA PROVIDER #
VA386481OtherANTHEM BC/BS PROVIDER ID
VA386481OtherANTHEM BC/BS PROVIDER ID
VA386479OtherANTHEM BC/BS PROVIDER ID#
VA00V388D06Medicare PIN
VAMG0929820OtherDEA LICENSE #