Provider Demographics
NPI:1144238726
Name:GILBERT, STUART G (MD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:G
Last Name:GILBERT
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 1:1 SPRUCE LN
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1196
Mailing Address - Country:US
Mailing Address - Phone:207-781-5192
Mailing Address - Fax:
Practice Address - Street 1:1 SPRUCE LN
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1196
Practice Address - Country:US
Practice Address - Phone:207-781-5192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0082452085R0001X, 2085R0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0203XAllopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME026369OtherANTHEM
NH30010315Medicaid
ME293560099Medicaid
MEM3006OtherCIGNA
ME1042367OtherAETNA
ME0005893606OtherAETNA/USHC
MEC66220OtherHPHC
ME030283Medicare ID - Type Unspecified
ME293560099Medicaid
NH30010315Medicaid