Provider Demographics
NPI:1922119791
Name:GILLMAN, DIANA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:MARIE
Last Name:GILLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:
Other - Last Name:GUTOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1650 FOURTH STREET SOUTHEAST
Mailing Address - Street 2:OLMSTED MEDICAL CENTER-HOSPITAL
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904
Mailing Address - Country:US
Mailing Address - Phone:507-529-6605
Mailing Address - Fax:507-529-6723
Practice Address - Street 1:1650 FOURTH STREET SOUTHEAST
Practice Address - Street 2:OLMSTED MEDICAL CENTER-HOSPITAL
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904
Practice Address - Country:US
Practice Address - Phone:507-529-6605
Practice Address - Fax:507-529-6723
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN42740207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology