Provider Demographics
NPI:1932283603
Name:GILMAN, RACHEL S (MD)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:S
Last Name:GILMAN
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 1:651 COLLIERS WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5053
Mailing Address - Country:US
Mailing Address - Phone:304-723-4700
Mailing Address - Fax:304-723-4719
Practice Address - Street 1:651 COLLIERS WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5053
Practice Address - Country:US
Practice Address - Phone:304-723-4700
Practice Address - Fax:304-723-4719
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083129C174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2005850000Medicaid
OH2439534Medicaid
OH2439534Medicaid
OH2439534Medicaid