Gilliam, Medrina B
Gilliam, Medrina B is an individual health care provider with primary practice located at 943 S Irby St , Florence SC 29501-5217. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Gilliam, Medrina B can be contacted via phone (843) 673-0075.Contact Information
Primary practice address
943 S Irby St
Florence SC 29501-5217
Phone: (843) 673-0075
Fax: (843) 673-0024
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 2919 | South Carolina |
Profile Details
| NPI number | 1952371783 |
|---|---|
| LBN Legal business name | Gilliam, Medrina B |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Dec 28th, 2010 - about 14 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 | 1952371783 | NPPES |
| South Carolina | MEDICAID | Z29194 |
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