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General NPI Number Information
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NPI Number | 1184078909
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Entity Type | Individual
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Provider Name | MICHELLE THERESE GILLIATTE M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 8901 RIVER CROSSING BLVD STE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-3985
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Country | US
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Telephone | 317-455-8540
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Fax | 317-455-8548
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Provider Business Mailing Address
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Address Line | 7535 EDGEWATER DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-3064
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Country | US
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Telephone | 317-379-4465
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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 | 207QB0002X
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Taxonomy Name | Obesity Medicine (Family Medicine) Physician
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License Number | 01080629A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01080629A
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License Number State | IN
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