# JOSH GILLIAM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1659535789
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA9104634 | FL | Yes |

## Other

- **Enumeration date:** 07/17/2008
- **Last updated:** 10/29/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000340900 | — | FL |
| 01 | — | P00982255 | RR MEDICARE | FL |