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GILLIAN ELECTA MAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
516 NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
(505) 722-1268
Mailing address
PO BOX 1337, GALLUP, NM 87305-1337
(505) 722-1000
(505) 722-1268

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35061091M
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000R4699
NM
05
416744
AZ
Enumeration date
03/22/2006
Last updated
04/23/2008
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