| Dr David Gannon, DPM | |
|
9956 N Main St, Suite #5, Berlin, MD 21811-1077 | |
| (410) 629-0222 | |
| (410) 629-0225 |
| Full Name | Dr David Gannon |
|---|---|
| Gender | Male |
| Speciality | Podiatry |
| Experience | 30 Years |
| Location | 9956 N Main St, Berlin, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376521492 | NPI | - | NPPES |
| E1-0000205 | Other | DE | STATE LICENSE |
| 3494004-00 | Medicaid | MD | |
| 6031730002 | Other | DE | DME |
| P00639639 | Other | MD | RAIL ROAD MEDICARE - INDIVIDUAL PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | E1-0000205 (Delaware) | Secondary |
| 213E00000X | Podiatrist | 01311 (Maryland) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Amedisys Home Health | Salisbury, MD | Home health agency |
| Atlantic General Hospital | Berlin, MD | Hospital |
| Peninsula Regional Medical Center | Salisbury, MD | Hospital |
| Provider Name | Atlantic General Hospital Corporation |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1871582171 PECOS PAC ID: 2365437837 Enrollment ID: O20040415000939 |
| Provider Name | David Gannon Dpm Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1861415200 PECOS PAC ID: 5294822433 Enrollment ID: O20071105000090 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr David Gannon, DPM 9956 N Main St, Suite #5, Berlin, MD 21811-1077 Ph: (410) 629-0222 | Dr David Gannon, DPM 9956 N Main St, Suite #5, Berlin, MD 21811-1077 Ph: (410) 629-0222 |
David Gannon Dpm Llc Podiatrist Medicare: Medicare Enrolled Practice Location: 9956 N Main St, Suite #5, Berlin, MD 21811 Phone: 410-629-0222 Fax: 410-629-0225 |