Provider Demographics
NPI:1952336406
Name:GILLESPIE, DAVID W (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:GILLESPIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1175 COOK RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-8201
Mailing Address - Country:US
Mailing Address - Phone:803-531-2300
Mailing Address - Fax:803-531-0133
Practice Address - Street 1:1175 COOK RD
Practice Address - Street 2:SUITE 145
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-8201
Practice Address - Country:US
Practice Address - Phone:803-531-2300
Practice Address - Fax:803-531-0133
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-01-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC10315207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
S332201OtherCIGNA
0701660OtherCAROLINA CARE PLAN
163555OtherUNISON
24298OtherMEDCOST
SC103159Medicaid
620716OtherSELECT HEALTH
SC160043684OtherRAILROAD MEDICARE
SC160043684OtherRAILROAD MEDICARE