Provider Demographics
NPI:1689986960
Name:GILMAN, DENISE IDA (DO)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:IDA
Last Name:GILMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 WELLNESS WAY
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-9720
Mailing Address - Country:US
Mailing Address - Phone:724-222-9500
Mailing Address - Fax:
Practice Address - Street 1:88 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-9720
Practice Address - Country:US
Practice Address - Phone:724-222-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015713208600000X
OH34.009908208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery