Healthcare Provider Details

I. General information

NPI: 1487231551
Provider Name (Legal Business Name): GELLMAN MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6330 N CENTER DR STE 206
NORFOLK VA
23502-4008
US

IV. Provider business mailing address

6330 N CENTER DR STE 206
NORFOLK VA
23502-4008
US

V. Phone/Fax

Practice location:
  • Phone: 573-356-6577
  • Fax:
Mailing address:
  • Phone: 757-971-3406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN GELLMAN
Title or Position: OWNER
Credential: MD
Phone: 757-971-3406