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General NPI Number Information
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NPI Number | 1033644554
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Entity Type | Individual
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Provider Name | LEE ELLIOT GILMAN MSN-AGNP, NP-C, RN
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Gender | Male
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5200 EASTERN AVE BLDG EAST2ND
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City | BALTIMORE
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State | MD
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Zip | 21224-2734
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Country | US
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Telephone | 410-550-2999
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Fax | 410-367-2442
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Provider Business Mailing Address
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Address Line | 5200 EASTERN AVE BLDG EAST
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City | BALTIMORE
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State | MD
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Zip | 21224-2734
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Country | US
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Telephone | 410-550-2999
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R209821
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | XG4336702
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | R209821
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | R209821
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License Number State | MD
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