person
Shannon L Gilliam, PA
Medical Physician Assistant in Waldorf, Maryland
NPI 1972548584

Shannon L Gilliam is a Medical Physician Assistant based in Coltons Point, MD and is specialized in Medical. Shannon L Gilliam practices in Waldorf, MD and has the professional credentials of PA. The NPI Number for Shannon L Gilliam is 1972548584 and holds a License No. C0003161 (Maryland).

The current practice location address for Shannon L Gilliam is 12070 Old Line Ctr Ste 303, Waldorf, MD and can be reached out via phone at 301-893-2505.

Location: 12070 Old Line Ctr Ste 303, Waldorf, MD, 20626-2102
person
Provider Profile Details
NPI Number
1972548584
Provider Name
Shannon L Gilliam
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
12070 Old Line Ctr Ste 303, Waldorf, MD, 20626-2102
Phone Number
301-893-2505
Fax Number
Provider Enumeration Date
06/18/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
12070 Old Line Ctr Ste 303
City
State
Zip
20602-3535
Phone Number
301-893-2505
Fax Number
person
Provider Business Mailing Address Details
Address
12070 Old Line Ctr Ste 303
City
State
Zip
20602-3535
Phone Number
301-893-2505
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
C0003161 (Maryland)
Definition
Definition to come...
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