Provider Demographics
NPI:1053632091
Name:GILBERT, DANIEL R (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:GILBERT
Suffix:
Gender:
Credentials:DO
Other - Prefix:DR
Other - First Name:DANIEL
Other - Middle Name:R
Other - Last Name:GILBERT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:10200 GRAND CENTRAL AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-4366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2530 E SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85204-5411
Practice Address - Country:US
Practice Address - Phone:480-834-4188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-14
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.144100208800000X
OH34010887208800000X, 390200000X
CA20A15720208800000X
AZ011043208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program