Provider Demographics
NPI:1982689212
Name:GILL, JAMES M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:GILL
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Gender:M
Credentials:MD
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Mailing Address - Street 1:213 GREENHILL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1844
Mailing Address - Country:US
Mailing Address - Phone:302-429-5870
Mailing Address - Fax:302-429-9284
Practice Address - Street 1:213 GREENHILL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1844
Practice Address - Country:US
Practice Address - Phone:302-429-5870
Practice Address - Fax:302-429-9284
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2012-08-30
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Provider Licenses
StateLicense IDTaxonomies
DEC10003368207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEE52205Medicare UPIN