Myriam Dawis Gilmore, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

N-6490 Issued in AR

Practice address

100 S Bliss Ave
Tahlequah, OK 74464-2512

Phone

(918) 458-3120

Fax

(918) 458-3511

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Myriam Villareal Dawis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1609900547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4425 BRANDT DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208016",
            "telephone_number": "918-458-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S BLISS AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744642512",
            "telephone_number": "918-458-3120",
            "fax_number": "918-458-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILMORE",
        "first_name": "MYRIAM",
        "middle_name": "DAWIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "N-6490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRIAM",
            "last_name": "DAWIS",
            "middle_name": "VILLAREAL",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael Gilchrist
• Raji M Gill, DO
• Russell O Gillette, LPC, LADC
• Abigail Christine Gillogly Harsch, O.D.
• Brett James Gillum
• Owen Buck Gilmore, M.D.
• Harold M Ginzburg, M.D.
• Nadine D. Givens
• Giving Tree Counseling PLLC
• Lisa G Glass

• Pediatrics Physician in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Pediatrics Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.