Provider Demographics
NPI:1346256237
Name:GITTELMAN, DAVID KALMAN (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KALMAN
Last Name:GITTELMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4280
Mailing Address - Street 2:170
Mailing Address - City:BUIES CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27506-4280
Mailing Address - Country:US
Mailing Address - Phone:910-893-1741
Mailing Address - Fax:910-893-1777
Practice Address - Street 1:4350 US 421 SOUTH
Practice Address - Street 2:170
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-4280
Practice Address - Country:US
Practice Address - Phone:910-893-1741
Practice Address - Fax:910-893-1777
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC334542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8935686Medicaid
NCE03556Medicaid
NC240016AMedicare ID - Type Unspecified
NC8935686Medicaid
NCE03556Medicare PIN
NCE03556Medicare UPIN