Individual
ROSE M GILLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 W LINCOLN AVE, GOSHEN, IN 46526-2413
(574) 534-4744
(574) 537-1186
Mailing address
400 W LINCOLN AVE, GOSHEN, IN 46526-2413
(574) 534-4744
(574) 537-1186
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01040912A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000500568
ANTHEM PIN
IN
05
—
100354290
—
IN
01
—
P00090607
RAILROAD MEDICARE PIN
—
Enumeration date
06/14/2006
Last updated
06/10/2022
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