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Individual

MR. LEE ELLIOT GILMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSN-AGNP, NP-C, RN

Contact information

Practice address
5200 EASTERN AVE BLDG EAST2ND, BALTIMORE, MD 21224-2734
(410) 550-2999
(410) 367-2442
Mailing address
5200 EASTERN AVE BLDG EAST, BALTIMORE, MD 21224-2734
(410) 550-2999

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R209821
MD
207QA0401X
Addiction Medicine (Family Medicine) Physician
XG4336702
MD
363LA2200X
Adult Health Nurse Practitioner
R209821
MD
363LP2300X
Primary Care Nurse Practitioner
Primary
R209821
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
126407960
MD
01
R209821
MARYLAND BOARD OF NURSING LICENSE
MD
Enumeration date
04/21/2017
Last updated
03/07/2023
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