Provider Demographics
NPI:1811073240
Name:COMISSIONG, GILBERT KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:GILBERT
Middle Name:KEITH
Last Name:COMISSIONG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:514 LOWER MAHOGANY RUN
Mailing Address - Street 2:
Mailing Address - City:ST. THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801
Mailing Address - Country:US
Mailing Address - Phone:340-775-2402
Mailing Address - Fax:
Practice Address - Street 1:SCHNEIDER REGIONAL MEDICAL CENTER
Practice Address - Street 2:
Practice Address - City:9048 SUGAR ESTATE
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-776-8311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1230208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VIH78518Medicare UPIN