National Provider Identifier Database

MARY R GILLAM, DO – NPI #1578143608
Pediatric Emergency Medicine

Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department.


Contact Information

MARY R GILLAM, DO
3601 W 13 MILE RD
ROYAL OAK, MI48073-6712
Phone: 248-898-0727
Fax:
Website:
Specialty Taxonomy Code
* Pediatric Emergency Medicine 207PP0204X
Student in an Organized Health Care Education/Training Program 390200000X

* Indicates primary specialty

NPI Profile & details for MARY R GILLAM

NPI Number 1578143608
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/13/2021
Last updated 01/28/2025 - More than a year ago
Sole proprietor1 No
Identifiers
  • MI License #: 5101027958
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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