Provider Demographics
NPI:1215985395
Name:GILL, JULIE (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:G
Other - Last Name:WIEHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:232 S WOODS MILL RD
Mailing Address - Street 2:SUITE 330 EAST
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3417
Mailing Address - Country:US
Mailing Address - Phone:314-205-6737
Mailing Address - Fax:
Practice Address - Street 1:232 S WOODS MILL RD
Practice Address - Street 2:SUITE 330 EAST
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3417
Practice Address - Country:US
Practice Address - Phone:314-205-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4350207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO241967OtherGROUP HEALTH PLAN
MOSP17022003OtherCIGNA
MO4412766OtherAETNA
MO135860OtherHEALTHLINK
MO135860OtherHEALTHLINK