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Individual

DR. NEIL BRYAN V GAMILLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1471 CHESTER BLVD, RICHMOND, IN 47374-1945
(765) 935-8581
(765) 935-1171
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8581
(765) 935-1171

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01067047A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000635116
ANTHEM - RPA
05
0072391
OH
05
200958830
IN
Enumeration date
07/07/2008
Last updated
05/13/2021
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