Individual
JONATHAN CALVIN GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1121 N CHURCH ST, GREENSBORO, NC 27401-1007
(336) 207-7055
Mailing address
5904 ARCADIA DR, GREENSBORO, NC 27410-3210
(919) 667-6150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
01/15/2025
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