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
Phone: (301) 893-2505
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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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