Healthcare Provider Details

I. General information

NPI: 1427058635
Provider Name (Legal Business Name): CAROL HUNTRESS GILMOUR MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE AGH NEONATOLOGY
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

1710 STURBRIDGE DR
SEWICKLEY PA
15143-8515
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-3164
  • Fax: 412-359-3663
Mailing address:
  • Phone: 412-359-3164
  • Fax: 412-359-3663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberMD039675E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: