Provider Demographics
NPI:1093011298
Name:ALLEN J GILSON M.D. LLC
Entity type:Organization
Organization Name:ALLEN J GILSON M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:GILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-662-5836
Mailing Address - Street 1:6695 STONE RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-2989
Mailing Address - Country:US
Mailing Address - Phone:301-662-5836
Mailing Address - Fax:301-620-9596
Practice Address - Street 1:6695 STONE RIDGE CT
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-2989
Practice Address - Country:US
Practice Address - Phone:301-662-5836
Practice Address - Fax:301-620-9596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0026516207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty