Provider Demographics
NPI:1508953977
Name:GILLIAM, JOHN HILLIARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HILLIARD
Last Name:GILLIAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1601 ROLLING HILLS DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5011
Mailing Address - Country:US
Mailing Address - Phone:804-270-4100
Mailing Address - Fax:804-270-7661
Practice Address - Street 1:1601 ROLLING HILLS DR
Practice Address - Street 2:SUITE 201
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5011
Practice Address - Country:US
Practice Address - Phone:804-270-4100
Practice Address - Fax:804-270-7661
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010376012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC47618Medicare UPIN