Provider Demographics
NPI:1417334640
Name:GILL, RABIA
Entity Type:Individual
Prefix:
First Name:RABIA
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:AMBULATORY CARE CENTER, 4TH FLOOR
Mailing Address - Street 2:417 N 11TH STREET
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23298-0340
Mailing Address - Country:US
Mailing Address - Phone:804-828-7700
Mailing Address - Fax:
Practice Address - Street 1:VIRGINIA COMMONWELATH UNIVERSITY, AMBULATORY CARE CENTE
Practice Address - Street 2:417 N 11TH STREET
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0340
Practice Address - Country:US
Practice Address - Phone:048-287-7008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-27
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101270362207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program