Provider Demographics
NPI:1366766263
Name:GILLIS, TAMA EVELYN (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:TAMA
Middle Name:EVELYN
Last Name:GILLIS
Suffix:
Gender:F
Credentials:MD,MPH
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1037 IRVING ST NE
Mailing Address - Street 2:1037 IRVING STREET NE
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-3419
Mailing Address - Country:US
Mailing Address - Phone:202-526-6830
Mailing Address - Fax:202-526-6830
Practice Address - Street 1:1037 IRVING STREET NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-3419
Practice Address - Country:US
Practice Address - Phone:202-526-6830
Practice Address - Fax:202-526-6830
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-22
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DC134562084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry