Provider Demographics
NPI:1770565897
Name:GILL, RUPINDER (MD)
Entity type:Individual
Prefix:MRS
First Name:RUPINDER
Middle Name:
Last Name:GILL
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:PO BOX 289
Mailing Address - Street 2:1428 N. GARDNER ST
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-0289
Mailing Address - Country:US
Mailing Address - Phone:812-752-1178
Mailing Address - Fax:812-752-1179
Practice Address - Street 1:1428 N GARDNER ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-7751
Practice Address - Country:US
Practice Address - Phone:812-752-1178
Practice Address - Fax:812-752-1179
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01053883A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200319400AMedicaid
IN177830Medicare ID - Type Unspecified
H32859Medicare UPIN