Provider Demographics
NPI:1609871797
Name:GIDEON, NANCY M (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:M
Last Name:GIDEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18947 JOHN J WILLIAMS HWY
Mailing Address - Street 2:SUITE 212
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971-4476
Mailing Address - Country:US
Mailing Address - Phone:302-645-8212
Mailing Address - Fax:302-645-2199
Practice Address - Street 1:18947 JOHN J WILLIAMS HWY
Practice Address - Street 2:SUITE 212
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4476
Practice Address - Country:US
Practice Address - Phone:302-645-8212
Practice Address - Fax:302-645-2199
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC10005362208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEG80563Medicare UPIN