Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 02001897A | IN |
N | 2080N0001X | Neonatal-Perinatal Doctor | 02832 | IA |
NPI | 1013999515 |
---|---|
Provider Name | Gail L Gilmore |
First Address | Indianapolis, IN 46250-2805 |
Second Address | Indianapolis, IN 46256-1695 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2005 |
Last Update Date | 28/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0297960 | (05) | IA |
H10381 | (02) |