Individual
MURIEL R GILLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 559-8374
(617) 421-3487
Mailing address
147 MILK ST, PROVIDER ENROLLMENT - 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8374
(617) 421-3487
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
48178
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
48178
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030868
NEIGHBORHOOD HEATLH
MA
05
—
0186007
—
MA
01
—
712306
TUFTS
MA
01
—
AA53
HARVARD PILGRIM
MA
01
—
E05954
BLUE CROSS
MA
Enumeration date
07/11/2006
Last updated
12/23/2013
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