MEDICARE: NEAL J GILMAN 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	2084N0400X	Neurology Physician	21710	CO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CP3228	OTHER	CO	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730169095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEAL J GILMAN M.D.

Provider Business Mailing Address
First Line	:	341 QUAIL DR
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81507-2526
Country	:	US
Telephone Number	:	970-242-1525
Fax Number	:

Provider Business Practice Location Address
First Line	:	341 QUAIL DR
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81507-2526
Country	:	US
Telephone Number	:	970-242-1525
Fax Number	:

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	09/19/2016

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