Provider Demographics
NPI:1609344274
Name:GILBERT, STEPHEN MARTIN (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:MARTIN
Last Name:GILBERT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374TH MDG YOKOTA AB UNIT 5071
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96328
Mailing Address - Country:US
Mailing Address - Phone:312-225-9475
Mailing Address - Fax:
Practice Address - Street 1:YOKOTA AB, JAPAN UNIT 5071
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96328
Practice Address - Country:US
Practice Address - Phone:315-225-8864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant