Bette Jean Gillerin, MD

Individual provider Active NPI Internal Medicine Physician · Pascoag, RI

NPI 1942390844 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1942390844
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
MD8610 (RI)
Practice address
2090 Wallum Lake Rd
Pascoag, RI 02859-1813
Phone
(401) 567-5400
NPI assigned
Oct 13, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD8610RIMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD8610 RI Yes

Addresses

Primary practice location

2090 Wallum Lake Rd
Pascoag, RI 02859-1813

Mailing address

2090 Wallum Lake Rd
Pascoag, RI 02859-1813
Phone (401) 567-5400

Other providers in Pascoag, RI

All providers in Pascoag, RI · Internal Medicine Physician in Rhode Island

Sources for this page

Verify at the official NPI Registry.