Provider Demographics
NPI:1891730933
Name:GAITER, THOMAS E SR (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:GAITER
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2024 GEORGIA AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3027
Mailing Address - Country:US
Mailing Address - Phone:202-865-3415
Mailing Address - Fax:202-865-6876
Practice Address - Street 1:2041 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20060-0001
Practice Address - Country:US
Practice Address - Phone:202-865-3200
Practice Address - Fax:202-865-3214
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
DCMD15905207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B92713Medicare UPIN
012340H13Medicare PIN