Healthcare Provider Details

I. General information

NPI: 1437198736
Provider Name (Legal Business Name): CHRISTOPHER J GILMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 BOWERS BLVD DEAN MEDICAL CENTER
DELAVAN WI
53115-1958
US

IV. Provider business mailing address

540 BOWERS BLVD DEAN MEDICAL CENTER
DELAVAN WI
53115-1958
US

V. Phone/Fax

Practice location:
  • Phone: 262-728-5568
  • Fax: 262-728-7837
Mailing address:
  • Phone: 262-728-5568
  • Fax: 262-728-7837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number41721-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: