Provider Demographics
NPI:1083648901
Name:M. JAVED GILANI MD, PA
Entity Type:Organization
Organization Name:M. JAVED GILANI MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVED
Authorized Official - Middle Name:
Authorized Official - Last Name:GILANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-478-7160
Mailing Address - Street 1:1309 VEALE RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4609
Mailing Address - Country:US
Mailing Address - Phone:302-478-7160
Mailing Address - Fax:302-478-7716
Practice Address - Street 1:1309 VEALE RD
Practice Address - Street 2:SUITE 11
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4609
Practice Address - Country:US
Practice Address - Phone:302-478-7160
Practice Address - Fax:302-478-7716
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10001737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1083648901Medicaid
DE0000748602Medicaid
DE0000748602Medicaid
DEC48673Medicare UPIN