Individual provider · NPI-1

Haywood S Gilliam, MD

Thoracic Surgery (Cardiothoracic Vascular Surgery) · Madison, WI

NPI number1316902091
StatusActive
Last updated in NPPESMar 25, 2008

Details

NPI
1316902091
Entity type
Individual (NPI-1)
Name
Haywood S Gilliam
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Apr 18, 2006
Last updated
Mar 25, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery)30734WIYes

Practice location

202 So Park St
Meriter Hospital
Madison, WI 53715

Phone 608-417-6387 · Fax 608-417-6198

Mailing address

202 So Park St
Meriter Hospital - 10 Tower
Madison, WI 53715

Phone 608-417-6387 · Fax 608-417-6198

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