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Individual

JOHN HUGH GILLIAM III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
22918
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
186131000
WV
01
24307
MEDCOST
01
35552
BCBS
01
4645549
AETNA
05
6057900
VA
01
8368
PARTNERS
05
8935552
NC
05
Q22918
SC
Enumeration date
12/09/2005
Last updated
05/08/2008
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