Gilliam, Bruce L.
Gilliam, Bruce L. is an individual health care provider with primary practice located at 22 S Greene St , Baltimore MD 21201-1544. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Gilliam, Bruce L. can be contacted via phone (410) 706-1372.Contact Information
Primary practice address
22 S Greene St
Baltimore MD 21201-1544
Phone: (410) 706-1372
Fax: (410) 706-4619
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Infectious Disease | 207RI0200X | D50956 | Maryland |
Profile Details
| NPI number | 1275583650 |
|---|---|
| LBN Legal business name | Gilliam, Bruce L. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2006 |
| Last updated | Nov 15th, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275583650 | NPPES |
| West Virginia | MEDICAID | 3810011136 | |
| West Virginia | Other | 608175-01 & 02 | |
| West Virginia | MEDICAID | 182200400 | |
| West Virginia | MEDICAID | 1275583650 |
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