Provider Demographics
NPI:1609895044
Name:GILMORE, ALLISON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:GILMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11100 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1716
Mailing Address - Country:US
Mailing Address - Phone:216-844-8338
Mailing Address - Fax:216-844-1122
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-069567207X00000X
OH35069567207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH363558OtherWELLCARE
OH000000214585OtherUNISON
OH2132463Medicaid
OH000000503692OtherANTHEM
PA1025795920001Medicaid
OH2132463OtherBCMH
OH738054OtherBUCKEYE
OH2465243OtherAETNA
OHP00011034OtherRAILROAD MEDICARE
OH738054OtherBUCKEYE
OH000000503692OtherANTHEM
OH2132463Medicaid