Provider Demographics
NPI:1487859021
Name:ISAAC, GILLIAN R (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:GILLIAN
Middle Name:R
Last Name:ISAAC
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:GILLIAN
Other - Middle Name:R
Other - Last Name:NEWMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:920 NEWINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21217-4631
Mailing Address - Country:US
Mailing Address - Phone:347-731-2607
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST # 1415
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21796207LC0200X
MDD69113207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD029466700Medicaid
MD029466700Medicaid