Individual
KEVIN ROBERT GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5901-B PEACHTREE DUNWOODY ROAD, ATLANTA, GA 30328-7156
(404) 252-9751
(404) 255-5783
Mailing address
5901-B PEACHTREE DUNWOODY ROAD, ATLANTA, GA 30328-7156
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
RN252629
GA
Other
Enumeration date
08/28/2016
Last updated
08/28/2016
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