Provider Demographics
NPI:1730331398
Name:GILBERT, MIRIAM E (NMD)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:E
Last Name:GILBERT
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 856
Mailing Address - Street 2:
Mailing Address - City:PATAGONIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85624
Mailing Address - Country:US
Mailing Address - Phone:520-394-2670
Mailing Address - Fax:520-394-2670
Practice Address - Street 1:456 W. NAUGLE
Practice Address - Street 2:
Practice Address - City:PATAGONIA
Practice Address - State:AZ
Practice Address - Zip Code:85624
Practice Address - Country:US
Practice Address - Phone:520-394-2670
Practice Address - Fax:520-394-2670
Is Sole Proprietor?:No
Enumeration Date:2008-10-15
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ88-391175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath