Provider Demographics
NPI:1386136299
Name:GILMORE, LINDSAY ERIN (MD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:ERIN
Last Name:GILMORE
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 1:2415 DEVON LN
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-1001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18TH MEDICAL GROUP
Practice Address - Street 2:UNIT 5124
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96328-5124
Practice Address - Country:US
Practice Address - Phone:904-294-6699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012680682080N0001X, 208D00000X
PAMT2234192080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice