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NPI Code Detail

MEDICARE: GAYLE FAITH TILLMAN MD

MEDICARE: GAYLE FAITH TILLMAN 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
12085R0001XRadiation Oncology Physician230183MA

Other Identifiers

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

General Provider Information

NPI Number : 1891709341
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAYLE FAITH TILLMAN MD
Provider Business Mailing Address
First Line : PO BOX 62
Second Line : TURNPIKE STATION
City : SHREWSBURY
State : MA
Zip : 01545-0062
Country : US
Telephone Number : 508-334-8815
Fax Number : 508-334-5374
Provider Business Practice Location Address
First Line : 55 LAKE AVE N
Second Line : DEPARTMENT OF RADIATION ONCOLOGY
City : WORCESTER
State : MA
Zip : 01655-0002
Country : US
Telephone Number : 508-856-2062
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 02/06/2026

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