JEREMY D GILLIAM

FORT WAYNE, IN
NPI1538284153
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: IN  01064785A)
Additional Taxonomies2085R0202X Radiology, Diagnostic Radiology
(Licence: KY  R1044)
2085R0202X Radiology, Diagnostic Radiology
(Licence: OH  35.091145)
Enumeration Date2007-03-20
Last Update Date2016-06-20
Business Address
Dr. JEREMY D GILLIAM MD
5001 US HIGHWAY 30 W STE D
FORT WAYNE, IN 46818-9701
Phone number: 260-432-4969
Mailing Address
Dr. JEREMY D GILLIAM MD
PO BOX 80070
FORT WAYNE, IN 46898-0070
Phone number: 260-432-1568