Provider Demographics
NPI:1205920337
Name:GILBERT, JANE L (MD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:L
Last Name:GILBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3433 PORTER STREET NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016
Mailing Address - Country:US
Mailing Address - Phone:301-654-6001
Mailing Address - Fax:301-654-6094
Practice Address - Street 1:5530 WISCONSIN AVENUE
Practice Address - Street 2:SUITE 530
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815
Practice Address - Country:US
Practice Address - Phone:301-654-6001
Practice Address - Fax:301-654-6094
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD21247207RR0500X
MDD0051999207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G49158Medicare UPIN
491-401Medicare ID - Type Unspecified