Healthcare Provider Details

I. General information

NPI: 1467476283
Provider Name (Legal Business Name): JANET DIANE B GILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANE B GILL MD

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 01/16/2024
Certification Date: 12/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ANNE ARUNDEL MEDICAL CENTER 2001 MEDICAL PARKWAY
ANNAPOLIS MD
21401-2140
US

IV. Provider business mailing address

469 JUMPERS HOLE RD APT 2201
SEVERNA PARK MD
21146-1771
US

V. Phone/Fax

Practice location:
  • Phone: 410-280-2260
  • Fax: 410-280-2290
Mailing address:
  • Phone: 530-774-5391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG66396
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0045620
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0101058578
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: