Individual
ELIZABETH E GILLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
360 SHERMAN ST, SUITE 399, SAINT PAUL, MN 55102-2564
(651) 356-6080
(651) 356-8486
Mailing address
360 SHERMAN ST, SUITE 399, SAINT PAUL, MN 55102-2564
(651) 356-6080
(651) 356-8486
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
42885
MN
2084N0400X
Neurology Physician
42885
MN
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
42885
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
849640400
—
MN
Enumeration date
09/08/2006
Last updated
03/18/2016
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