MEDICARE: DR. JOAN H GILL M.D.

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
1	2084P0800X	Psychiatry Physician	M-1018	GU

General Provider Information

NPI Number	:	1669423117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOAN H GILL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 12623
Second Line	:
City	:	TAMUNING
State	:	GU
Zip	:	96931-2623
Country	:	US
Telephone Number	:	671-344-9200
Fax Number	:	671-472-7249

Provider Business Practice Location Address
First Line	:	VETERANS CLINIC, USNH
Second Line	:	BUILDING E - 200
City	:	AGANA HEIGHTS
State	:	GU
Zip	:	96919
Country	:	US
Telephone Number	:	671-344-9200
Fax Number	:	671-472-7249

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/08/2007

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