Doctor Name: | TEDRA GILMORE |
NPI Number: | 1205928223 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | ME 98980 |
Business Practice Address: | 769 N Clyde Morris Blvd Daytona Beach, FL - 321141603 |
Business Phone Number: | 3862580123 |
Business Fax Number: | 3862586882 |
Mailing Address: | 769 N Clyde Morris Blvd, DAYTONA BEACH |
State: | FL |
Postal Code: | 321141603 |
Phone Number: | 3862580123 |
Fax Number: | 3862586882 |
NPI Enumeration Date: | 09/28/2006 |
NPI Last Update Date: | 08/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | ME 98980 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |