Provider Demographics
NPI:1184956492
Name:GAMERMAN, DAVID SAMUEL (OD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SAMUEL
Last Name:GAMERMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 TUFTON SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-5542
Mailing Address - Country:US
Mailing Address - Phone:443-520-8585
Mailing Address - Fax:410-561-4742
Practice Address - Street 1:2309 TUFTON SPRINGS LN
Practice Address - Street 2:
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-5542
Practice Address - Country:US
Practice Address - Phone:443-520-8585
Practice Address - Fax:410-561-4742
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0882152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management