Provider Demographics
NPI:1982718383
Name:VERA, GILBERTO A (MD)
Entity Type:Individual
Prefix:DR
First Name:GILBERTO
Middle Name:A
Last Name:VERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:PROF
Other - First Name:RENAL
Other - Middle Name:SERVICES,
Other - Last Name:P.C.
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1404 GOWER CT
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-2732
Mailing Address - Country:US
Mailing Address - Phone:703-734-0894
Mailing Address - Fax:
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:SUITE 16
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2107
Practice Address - Country:US
Practice Address - Phone:202-526-8833
Practice Address - Fax:202-526-8622
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD20169174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCP00066999OtherMEDICARE RR
DC490871Medicare PIN
DCF81572Medicare UPIN