Gilliam, Ryan Dwain

Gilliam, Ryan Dwain is an individual health care provider with primary practice located at 2311 Lewisville Clemmons Rd , Clemmons NC 27012-8905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gilliam, Ryan Dwain can be contacted via phone (336) 713-8900.

Contact Information

Primary practice address
2311 Lewisville Clemmons Rd Clemmons NC 27012-8905
Phone: (336) 713-8900
Fax: (336) 702-9286
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X RTL North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 200901294 North Carolina

Profile Details

NPI number 1538201629
LBN Legal business name Gilliam, Ryan Dwain
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2007
Last updated Oct 23rd, 2023 - about 3 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 1538201629 NPPES
North Carolina MEDICAID 5912191

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