Provider Demographics
NPI:1184641045
Name:GILLIGAN, DAVID MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARTIN
Last Name:GILLIGAN
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 1:8001 FRANKLIN FARMS DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5108
Mailing Address - Country:US
Mailing Address - Phone:804-521-5800
Mailing Address - Fax:804-545-4340
Practice Address - Street 1:8700 STONY POINT PKWY STE 120
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235-1965
Practice Address - Country:US
Practice Address - Phone:804-323-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101051833207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1330798OtherCIGNA
VA2535453OtherAETNA/US HEALTHCARE HMO
VA276296OtherANTHEM/VA HEALTHKEEPERS
VA294609OtherMAMSI
VA38055OtherSENTARA HEALTH/OPTIMA
VA276229OtherANTHEM/VA HEALTHKEEPERS
VA276271OtherANTHEM/VA HEALTHKEEPERS
VA25-01089OtherUNITED HEALTHCARE
VA27413300OtherFEDERAL BLACK LUNG
VA103823OtherANTHEM/VA HEALTHKEEPERS
VA4604722OtherAETNA/US HEALTHCARE
VA135973OtherSOUTHERN HEALTH SERVICES
VA276198OtherANTHEM/VAHEALTHKEEPERS
VA5854067Medicaid
VA276247OtherANTHEM/VA HEALTHKEEPERS
VA276353OtherANTHEM/VA HEALTHKEEPERS
VA60063465OtherRAILROAD MEDICARE
VA276198OtherANTHEM/VAHEALTHKEEPERS
VA38055OtherSENTARA HEALTH/OPTIMA