Healthcare Provider Details

I. General information

NPI: 1467640318
Provider Name (Legal Business Name): NAMITA GILL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2007
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2771 HEMLOCK ST STE 201
BREMERTON WA
98310-2689
US

IV. Provider business mailing address

2771 HEMLOCK ST STE 201
BREMERTON WA
98310-2689
US

V. Phone/Fax

Practice location:
  • Phone: 360-377-7634
  • Fax: 360-479-6157
Mailing address:
  • Phone: 360-377-7634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD00048901
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD00048901
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD00048901
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: