Provider Demographics
NPI:1972508463
Name:GILBERT, MICHAEL ERIK (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ERIK
Last Name:GILBERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 N SYRINGA ST
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-8794
Mailing Address - Country:US
Mailing Address - Phone:208-777-1320
Mailing Address - Fax:208-777-1322
Practice Address - Street 1:849 N SYRINGA ST
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-8794
Practice Address - Country:US
Practice Address - Phone:208-777-1320
Practice Address - Fax:208-777-1322
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-8990207Y00000X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806893800Medicaid
IDI09178Medicare UPIN
ID1126831Medicare ID - Type Unspecified