Provider Demographics
NPI:1013961283
Name:GILMORE, MICHAEL DOW (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DOW
Last Name:GILMORE
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 1:2401 LANGLEY AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8922
Mailing Address - Country:US
Mailing Address - Phone:850-407-7840
Mailing Address - Fax:850-407-7839
Practice Address - Street 1:2401 LANGLEY AVE UNIT B
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8922
Practice Address - Country:US
Practice Address - Phone:850-407-7840
Practice Address - Fax:850-407-7839
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83504207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL43258OtherINDIVIDUAL BLUE CROSS
FLP00149196OtherRAILROAD MEDICARE
FL43258OtherINDIVIDUAL BLUE CROSS
FL43258ZMedicare ID - Type UnspecifiedINDIVIDUAL IDENTIFICATION
FL270563000Medicaid