Individual
BRENT WINSTON GILLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4727 SAINT ANTOINE ST, SUITE 210, DETROIT, MI 48201-1461
(313) 831-3066
(313) 831-8438
Mailing address
4727 SAINT ANTOINE ST, SUITE 210, DETROIT, MI 48201-1461
(313) 831-3066
(313) 831-8438
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
007845
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3118130
—
MI
Enumeration date
02/27/2006
Last updated
06/14/2010
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