Provider Demographics
NPI:1295902898
Name:DELOSREYES, GIL ERNESTO TAVANLAR (MD)
Entity type:Individual
Prefix:DR
First Name:GIL ERNESTO
Middle Name:TAVANLAR
Last Name:DELOSREYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 CURRY AVENUE
Mailing Address - Street 2:
Mailing Address - City:CONOWINGO
Mailing Address - State:MD
Mailing Address - Zip Code:21918-1451
Mailing Address - Country:US
Mailing Address - Phone:443-299-8938
Mailing Address - Fax:
Practice Address - Street 1:46 CURRY AVENUE
Practice Address - Street 2:
Practice Address - City:CONOWINGO
Practice Address - State:MD
Practice Address - Zip Code:21918-1451
Practice Address - Country:US
Practice Address - Phone:443-299-8938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD17677208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice