Gillum, Brent Winston

Gillum, Brent Winston is an individual health care provider with primary practice located at 4727 Saint Antoine St Suite 210, Detroit MI 48201-1461. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Gillum, Brent Winston can be contacted via phone (313) 831-3066.

Contact Information

Primary practice address
4727 Saint Antoine St Suite 210 Detroit MI 48201-1461
Phone: (313) 831-3066
Fax: (313) 831-8438
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 007845 Michigan

Profile Details

NPI number 1659347821
LBN Legal business name Gillum, Brent Winston
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 27th, 2006
Last updated Jun 14th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659347821 NPPES
Michigan MEDICAID 3118130

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