Brent W Gillum D O Plc

LBN: Brent W Gillum D O Plc
Brent W Gillum D O Plc is an health care organization with primary practice located at 4727 Saint Antoine St Suite 210, Detroit MI 48201-1461. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as the primary health care specialty. Brent W Gillum D O Plc can be contacted via phone (313) 831-3066, or through Gillum, Brent Winston via phone (313) 831-3066.

Contact Information

Primary practice address
4727 Saint Antoine St Suite 210 Detroit MI 48201-1461
Fax: (313) 831-8438
Website:
Authorized official contact:
Name: Gillum, Brent Winston Doctor of Osteopathy (DO)

Health care specialties

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

Profile Details

NPI number 1710926670
LBN Legal business name Brent W Gillum D O Plc
DBA Doing business as
Authorized official Gillum, Brent Winston Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 6th, 2006
Last updated Nov 7th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710926670 NPPES
Michigan MEDICAID 4850953

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