Gilliam, Shannon L

Gilliam, Shannon L is an individual health care provider with primary practice located at 12070 Old Line Ctr Ste 303 , Waldorf MD 20602-3535. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Gilliam, Shannon L can be contacted via phone (301) 893-2505.

Contact Information

Primary practice address
12070 Old Line Ctr Ste 303 Waldorf MD 20602-3535
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X C0003161 Maryland

Profile Details

NPI number 1972548584
LBN Legal business name Gilliam, Shannon L
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2006
Last updated Feb 24th, 2020 - about 5 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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