Provider Demographics
NPI:1710137906
Name:GILES, HANNELORE HENDYGAIN (MD)
Entity Type:Individual
Prefix:DR
First Name:HANNELORE
Middle Name:HENDYGAIN
Last Name:GILES
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 1:2500 SIERRA CIR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-2540
Mailing Address - Country:US
Mailing Address - Phone:601-268-3123
Mailing Address - Fax:601-261-9053
Practice Address - Street 1:2500 SIERRA CIR
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-2540
Practice Address - Country:US
Practice Address - Phone:601-268-3123
Practice Address - Fax:601-261-9053
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS05737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSC48443Medicare UPIN