Provider Demographics
NPI:1225188535
Name:TILL, ANN G (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:G
Last Name:TILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:MARIE
Other - Last Name:GALLAGHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:860 1ST AVE
Mailing Address - Street 2:SUITE 4B
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406
Mailing Address - Country:US
Mailing Address - Phone:610-265-1251
Mailing Address - Fax:610-265-1252
Practice Address - Street 1:860 FIRST AVE STE 4B
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4033
Practice Address - Country:US
Practice Address - Phone:610-265-1251
Practice Address - Fax:610-265-1252
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD430059207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7205846OtherAETNA
PA1978047OtherBS
PA7205846OtherAETNA
PA1978047OtherBS