Provider Demographics
NPI:1417986233
Name:GILL, DAWN (OD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 HAYWARD RD
Mailing Address - Street 2:STE 202
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2509
Mailing Address - Country:US
Mailing Address - Phone:301-662-8866
Mailing Address - Fax:301-662-8890
Practice Address - Street 1:7420 HAYWARD RD STE 202
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-2509
Practice Address - Country:US
Practice Address - Phone:301-662-8866
Practice Address - Fax:301-662-8890
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1338152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
60645801OtherCAREFIRST BCBS
60645901OtherBLUE CROSS BLUE SHIELD
1078176OtherAETNA-HMO
271520OtherMAMSI/UNITED HEALTHCARE
620428OtherHEALTHLINK/NCPPO
620428OtherUNICARE
271520OtherONENET
0002OtherBCBS FEP
271520OtherMDIPA
271520OtherALLIANCE
5041476OtherAETNA
271520OtherOPTIMUM CHOICE
MDU61466Medicare UPIN
MD603EMedicare PIN