Individual
DR. SHANNON CHARISSE GILHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
4176 STATE ROUTE 306, WILLOUGHBY, OH 44094
(440) 918-4630
(440) 918-4632
Mailing address
7590 AUBURN ROAD, SUITE 014, ATTN: MED STAFF, CONCORD TWP, OH 44077-9176
(440) 354-1899
(440) 354-1845
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0102202019
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508074931
BCBS
VA
05
—
1508074931
—
VA
Enumeration date
05/18/2007
Last updated
03/03/2021
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