Individual
GARY P DILLON
Active
Individual
GARY P DILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
01024462A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340592
ANTHEM
IN
01
—
000000705135
ANTHEM PROVIDER PIN / TIN 35-2030653
IN
05
—
100340440
—
IN
Enumeration date
07/31/2006
Last updated
10/01/2013
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