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General NPI Number Information
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NPI Number | 1134372592
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Entity Type | Individual
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Provider Name | TYSON D GILLMEN DO
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Gender | Male
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 09/01/2022
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Provider Practice Location Address
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Address Line | 4800 FRIENDSHIP AVE
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City | PITTSBURGH
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State | PA
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Zip | 15224-1722
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Country | US
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Telephone | 412-578-5323
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Fax | 412-605-6425
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Provider Business Mailing Address
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Address Line | 100 APRILMAE WAY
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City | PITTSBURGH
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State | PA
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Zip | 15237-2745
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Country | US
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Telephone | 814-330-2056
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Fax | 412-359-3483
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | OS022054
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License Number State | PA
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