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NPI Code Detail

MEDICARE: DR. WARREN GILLETTE JR. MD

MEDICARE: DR. WARREN GILLETTE JR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician20124AZ
2207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianMD463045PA
3174400000XSpecialist20124AZ

General Provider Information

NPI Number : 1649221870
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WARREN GILLETTE JR. MD
Provider Business Mailing Address
First Line : 1253 COLLEGE PARK DR
Second Line :
City : DOVER
State : DE
Zip : 19904-8713
Country : US
Telephone Number : 302-677-0000
Fax Number :
Provider Business Practice Location Address
First Line : 1253 COLLEGE PARK DR
Second Line :
City : DOVER
State : DE
Zip : 19904-8713
Country : US
Telephone Number : 302-677-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2006
Last Update Date : 07/05/2018

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