Provider Demographics
NPI:1528061900
Name:GILL, HARBANS S (MD)
Entity type:Individual
Prefix:
First Name:HARBANS
Middle Name:S
Last Name:GILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19398 NEWCOM KNLS
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-8948
Mailing Address - Country:US
Mailing Address - Phone:812-539-4204
Mailing Address - Fax:
Practice Address - Street 1:276 BIELBY RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-2787
Practice Address - Country:US
Practice Address - Phone:812-537-1740
Practice Address - Fax:812-537-7042
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01024738207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC24501Medicare UPIN
IN170960Medicare ID - Type Unspecified