Provider Demographics
NPI:1790255925
Name:GILLIAM, ARTHUR ALFONZO
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:ALFONZO
Last Name:GILLIAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-8699
Mailing Address - Country:US
Mailing Address - Phone:828-505-3086
Mailing Address - Fax:828-274-6377
Practice Address - Street 1:6 ROBERTS RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-8699
Practice Address - Country:US
Practice Address - Phone:828-505-3086
Practice Address - Fax:828-274-6377
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-30
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)