Provider Demographics
NPI:1477190981
Name:GILLIAM, BARRY (CRS)
Entity Type:Individual
Prefix:
First Name:BARRY
Middle Name:
Last Name:GILLIAM
Suffix:
Gender:M
Credentials:CRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1789 S BRADDOCK AVE STE 550
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1880
Mailing Address - Country:US
Mailing Address - Phone:412-723-1749
Mailing Address - Fax:412-346-4319
Practice Address - Street 1:1789 S BRADDOCK AVE STE 550
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1880
Practice Address - Country:US
Practice Address - Phone:412-723-1749
Practice Address - Fax:412-346-4319
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-03
Last Update Date:2022-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist