Bradley, Jeremy Gilliam

Bradley, Jeremy Gilliam is an individual health care provider with primary practice located at 633D Medical Group 77 Nealy Avenue, Joint Base Langely-Eusits VA 23665-2040. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Bradley, Jeremy Gilliam can be contacted via phone (757) 225-7630.

Contact Information

Primary practice address
633D Medical Group 77 Nealy Avenue Joint Base Langely-Eusits VA 23665-2040
Phone: (757) 225-7630
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101258260 Virginia

Profile Details

NPI number 1922362722
LBN Legal business name Bradley, Jeremy Gilliam
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2012
Last updated Apr 26th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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