Provider Demographics
NPI:1386646065
Name:GILBERT, MICHAEL L (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:L
Last Name:GILBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12301 NE 10TH PL STE 200
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2487
Mailing Address - Country:US
Mailing Address - Phone:425-450-2020
Mailing Address - Fax:425-688-0620
Practice Address - Street 1:12301 NE 10TH PL STE 200
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2487
Practice Address - Country:US
Practice Address - Phone:425-450-2020
Practice Address - Fax:425-688-0620
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027511207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAB65137Medicare UPIN
WAGAB22158Medicare PIN
WA1063395Medicaid