Gilliam, Tifani Davis
Gilliam, Tifani Davis is an individual health care provider with primary practice located at 2121 Medical Park Dr Ste 3, Silver Spring MD 20902-4054. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Gilliam, Tifani Davis can be contacted via phone (301) 681-3003.Contact Information
Primary practice address
2121 Medical Park Dr Ste 3
Silver Spring MD 20902-4054
Phone: (301) 681-3003
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD035810 | District of Columbia |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | D66654 | Maryland |
Profile Details
| NPI number | 1952320459 |
|---|---|
| LBN Legal business name | Gilliam, Tifani Davis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Jan 20th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952320459 | NPPES |
| Maryland | MEDICAID | 410243601 |
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