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Contact Information

DAVID GANNON, DPM
9956 N MAIN ST
SUITE #5
BERLIN, MD21811-1077
 Phone: 410-629-0222
 Fax: 410-629-0225
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for DAVID GANNON · (Male)

NPI Number 1376521492
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 01/09/2006
Last updated 04/05/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • DE License # E1-0000205
  • MD License # 01311
  • MD Medicaid 3494004-00
  • DE Other 6031730002 DME
  • DE Other E1-0000205 STATE LICENSE
  • MD Other P00639639 RAIL ROAD MEDICARE - INDIVIDUAL PTAN
Hospital affiliation(s)
  • ATLANTIC GENERAL HOSPITAL - (Acute Care)
    9733 HEALTHWAY DRIVE
    BERLIN, MD 21811
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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