Individual
MR. FREDERICK DWAYNE GILLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
820 S AKERS ST STE 120, VISALIA, CA 93277-8306
(559) 625-4118
(559) 625-6004
Mailing address
820 S AKERS ST STE 120, VISALIA, CA 93277-8306
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
52887
CA
363AS0400X
Surgical Physician Assistant
Primary
52887
CA
Other
Enumeration date
10/01/2015
Last updated
01/06/2025
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