DR. DIANE GILLUM (NPI# 1174511091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174511091 |
| Entity Type | Individual |
| Full Name | DR. DIANE GILLUM |
| Credential | M.D |
| Practice Address |
2 Cooper Plaza, 400 Haddon Ave Camden NJ 08103-1461 |
| Mailing Address |
1 Federal St Ste Sw200 Camden NJ 08103-1155 |
| Practice Telephone | 8556322667 |
| Mailing Telephone | 8563564924 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2020-10-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 25MA04930700 | NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 2395207 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1605 E Evesham Rd, Suite 2b, Voorhees, NJ 080431437 | 8564248004 | 8564248007 |
| Street Address |
2 COOPER PLAZA, 400 HADDON AVE |
| City | CAMDEN |
| State | NJ |
| Zip Code | 08103-1461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516063 | Toni Marie Primas | Registered Nurse | Sheridan Pavilion, Three Cooper Plaza Suite 220, Camden, NJ 08103 | 2020-07-24 |
| 1376028548 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 805-815 Federal Street, Camden, NJ 08103 | 2018-10-03 |
| 1942795802 | Kyle Richard Marden | Student in an Organized Health Care Education/Training Program | 401 Haddon Avenue, 2nd Floor Room 266, Camden, NJ 08103 | 2018-06-24 |
| 1588157473 | Julio Antonio Rodriguez Jr. | Student in an Organized Health Care Education/Training Program | Cooper University Hospital, 3 Cooper Plaza Suite 408, Camden, NJ 08103 | 2018-06-14 |
| 1386149748 | Shuchi Gupta | Nurse Practitioner | 519 West Street, Camden, NJ 08103 | 2018-03-28 |
| 1326541491 | Bolanle Idowu-akangbe | Nurse Practitioner | 519-525 West Street, Camden, NJ 08103 | 2018-03-14 |
| 1740709500 | New Beginnings Behavioral Health | Clinic/Center | 1300 Princess Avenue, Camden, NJ 08103 | 2017-09-13 |
| 1760905012 | Loraine Morris | Counselor | 1479 Kaighn Ave, Camden, NJ 08103 | 2017-07-19 |
| 1386164333 | Matthew Share | Genetic Counselor, MS | Two Cooper Plaza, 400 Haddon Avenue, Md Anderson Cancer Center, Camden, NJ 08103 | 2017-06-21 |
| 1568902070 | Cooper University Hospital | General Acute Care Hospital | 1 Cooper Plaza, Dorrance 222, Camden, NJ 08103 | 2017-03-02 |
| Find all providers in zip 08103 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801162268 | Jennifer Margaret Burg | Surgery | Cooper Surgical Associates, Sheridan Pavilion, 3 Cooper, Suite 411, Camden, NJ 08103 | 2012-03-29 |
| 1972747517 | Michael Trayser Dunaway | Surgery | 1413 Mill St, Camden, SC 29020-2934 | 2009-04-27 |
| 1831345461 | David Daniel Shersher | Surgery | 3 Cooper Plz Rm 221, Camden, NJ 08103-1438 | 2008-08-14 |
| 1720020647 | Mark A Shina | Surgery | 415 Hospital Dr Ste 3, Camden, AR 71701 | 2006-06-12 |
| 1326099912 | Edward A Gill | Surgery | 1102 Roberts St, Camden, SC 29020-3734 | 2006-05-16 |
| 1962486761 | Prakash Vaidy | Surgery | 379 Walmart Dr, Camden, DE 19934-1365 | 2005-12-05 |
| 1215479159 | Ouachita Physician Services, LLC | Surgery | 415 Hospital Dr, Ste. 3, Camden, AR 71701-4615 | 2016-11-09 |
| 1366998619 | Alireza Mofid | Surgery | 1 Cooper Plz, Camden, NJ 08103 | 2016-08-28 |
| 1437549482 | William Matthew Harris | Surgery | 1600 Haddon Ave, Camden, NJ 08103 | 2015-01-29 |
| 1457764169 | Kershawhealth | Surgery | 1102 Roberts St, Camden, SC 29020-3734 | 2014-06-10 |
| Find all providers in CAMDEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.