Gillum, Jeffrey

Gillum, Jeffrey is an individual health care provider with primary practice located at 4727 Saint Antoine St Suite 210, Detroit MI 48201-1461. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Gillum, Jeffrey can be contacted via phone (313) 831-3066.

Contact Information

Primary practice address
4727 Saint Antoine St Suite 210 Detroit MI 48201-1461
Phone: (313) 831-3066
Fax: (313) 831-8438
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 4301041555 Michigan

Profile Details

NPI number 1790773091
LBN Legal business name Gillum, Jeffrey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Feb 1st, 2010 - about 15 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 1790773091 NPPES
Michigan MEDICAID 5215491
Michigan MEDICAID 4502243
Michigan MEDICAID 5188750

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