Gilliam, Oliver D

Gilliam, Oliver D is an individual health care provider with primary practice located at 17501 Generations Dr , South Bend IN 46635-1589. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Gilliam, Oliver D can be contacted via phone (574) 234-0049.

Contact Information

Primary practice address
17501 Generations Dr South Bend IN 46635-1589
Phone: (574) 234-0049
Fax: (574) 251-2861
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 01035882A Indiana

Profile Details

NPI number 1497759765
LBN Legal business name Gilliam, Oliver D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2005
Last updated Jan 21st, 2011 - about 13 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 1497759765 NPPES
Indiana MEDICAID 100090510
Indiana Other 2738533002
Indiana Other 000000084427
Indiana Other 4667992
Indiana Other 100010837

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