Individual
ELIZABETH GILLENWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 662-6305
Mailing address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4206
(215) 662-6305
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MT202347
PA
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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