Provider Demographics
NPI:1255686770
Name:GILMET, ERIC STEPHEN (SOIDC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:STEPHEN
Last Name:GILMET
Suffix:
Gender:M
Credentials:SOIDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 LAWNDALE LN
Mailing Address - Street 2:
Mailing Address - City:SNEADS FERRY
Mailing Address - State:NC
Mailing Address - Zip Code:28460-6807
Mailing Address - Country:US
Mailing Address - Phone:910-381-5336
Mailing Address - Fax:
Practice Address - Street 1:161 LAWNDALE LN
Practice Address - Street 2:
Practice Address - City:SNEADS FERRY
Practice Address - State:NC
Practice Address - Zip Code:28460-6807
Practice Address - Country:US
Practice Address - Phone:910-381-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman