Jeffrey Gillum, MD
Obstetrics & Gynecology in Detroit, MI. Individual provider (NPI-1).
NPI number1790773091
StatusActive
Last updated in NPPESFeb 1, 2010
Details
- NPI
- 1790773091
- Entity type
- Individual (NPI-1)
- Name
- Jeffrey Gillum
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 11, 2005
- Last updated
- Feb 1, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | 4301041555 | MI | Yes |
Practice location
4727 Saint Antoine StSuite 210
Detroit, MI 48201-1461
Phone 313-831-3066 · Fax 313-831-8438
Mailing address
43800 Garfield RdClinton Twp, MI 48038-1136
Phone 800-848-0202 · Fax 586-226-6949
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