Provider Demographics
NPI:1164487468
Name:GILMAN, PHILIP BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:BRIAN
Last Name:GILMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 W CHESTER PIKE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-3442
Mailing Address - Country:US
Mailing Address - Phone:610-789-3510
Mailing Address - Fax:610-789-3591
Practice Address - Street 1:1010 W CHESTER PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3442
Practice Address - Country:US
Practice Address - Phone:610-789-3510
Practice Address - Fax:610-789-3591
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031610E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC30956Medicare UPIN
PAC30956Medicare UPIN