Provider Demographics
NPI:1811099567
Name:GILIN, SEAN E (MD)
Entity type:Individual
Prefix:DR
First Name:SEAN
Middle Name:E
Last Name:GILIN
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 1:8483 HOLLY RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1840
Mailing Address - Country:US
Mailing Address - Phone:810-694-7820
Mailing Address - Fax:810-694-6955
Practice Address - Street 1:8483 HOLLY RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1840
Practice Address - Country:US
Practice Address - Phone:810-694-0113
Practice Address - Fax:810-694-0020
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301059912207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3399970Medicaid
MIG21800Medicare UPIN
MIM23560094Medicare PIN