Provider Demographics
NPI:1750348421
Name:GILBERT, CHRISTIAN L (MD)
Entity type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:L
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:PO BOX 547
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-0547
Mailing Address - Country:US
Mailing Address - Phone:843-663-8013
Mailing Address - Fax:910-202-9966
Practice Address - Street 1:4303 LIVE OAK DR
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-9138
Practice Address - Country:US
Practice Address - Phone:843-663-8013
Practice Address - Fax:843-663-8166
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035160E207QA0401X
DEC1-0013325207QA0401X
NC2022-00312207QA0401X, 207R00000X, 2084P0800X
SC85777207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1750348421Medicaid
TN3890215Medicaid
TN3890215Medicaid
3890215Medicare ID - Type Unspecified