JEFFREY GILLUM (NPI# 1790773091) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790773091 |
| Entity Type | Individual |
| Full Name | JEFFREY GILLUM |
| Credential | MD |
| Practice Address |
4727 Saint Antoine St Suite 210 Detroit MI 48201-1461 |
| Mailing Address |
43800 Garfield Rd Clinton Twp MI 48038-1136 |
| Practice Telephone | 3138313066 |
| Practice Fax Number | 3138318438 |
| Mailing Telephone | 8008480202 |
| Mailing Fax Number | 5862266949 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2010-02-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 4301041555 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4502243 | 05 | |
| MI | 5188750 | 05 | |
| MI | 5215491 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548235542 | Jeffrey Thomas Gillum | Physical Therapist | 1280 Doctors Dr, Farmington, MO 63640-2932 | 2006-02-22 |
| Street Address |
4727 SAINT ANTOINE ST SUITE 210 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-1461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083146906 | S Madani Md PC | Pediatrics | 4727 Saint Antoine St, Suite 402, Detroit, MI 48201-1461 | 2017-03-30 |
| 1750737821 | Selice Jenae Zooper | Dental Hygienist | 4727 Saint Antoine St, Suite 408, Detroit, MI 48201-1461 | 2016-05-09 |
| 1275989352 | Mya Weeks | Dental Hygienist | 4727 Saint Antoine St, Suite 408, Detroit, MI 48201-1461 | 2016-05-09 |
| 1386098663 | Lucas Perry Dental Group | Clinic/Center | 4727 Saint Antoine St, Suite 408, Detroit, MI 48201-1461 | 2016-04-22 |
| 1558769836 | Global Health Ipa | Family Medicine | 4727 Saint Antoine St, Ste 202, Detroit, MI 48201-1461 | 2014-12-18 |
| 1265841977 | Latonya Waller | Dentist | 4727 Saint Antoine St, Detroit, MI 48201-1461 | 2014-08-06 |
| 1902213689 | Hutzel Womens Health Specialists | Obstetrics & Gynecology | 4727 Saint Antoine St, Suite 304, Detroit, MI 48201-1461 | 2014-07-15 |
| 1093134348 | Jackson Health Services | Family Medicine | 4727 Saint Antoine St, Ste 202, Detroit, MI 48201-1461 | 2014-04-15 |
| 1093145377 | Metro Womens Health Pllc | Obstetrics & Gynecology | 4727 Saint Antoine St, Suite 304, Detroit, MI 48201-1461 | 2013-11-22 |
| 1558794594 | Bobbi Rae Emmons | Dental Hygienist | 4727 Saint Antoine St, Suite 408, Detroit, MI 48201-1461 | 2013-08-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992009955 | Maurice-andre Recanati | Obstetrics & Gynecology | 4201 Saint Antoine St Ste 4c, Detroit, MI 48201-2153 | 2011-01-06 |
| 1194041830 | Eberechukwu Jill Azumah | Obstetrics & Gynecology | 5960 Bedford St, Detroit, MI 48224-2651 | 2010-04-19 |
| 1134383508 | Haider S Mahdi | Obstetrics & Gynecology | 3990 John R, 7 Brush North, Wayne State University/ Detroit Medical Center,obgyn, Detroit, MI 48201 | 2008-07-15 |
| 1609040484 | Yhfmc PC | Obstetrics & Gynecology | 15266 Grand River Ave, Detroit, MI 48227-2213 | 2008-04-14 |
| 1619191954 | F Seabrooks | Obstetrics & Gynecology | 19305 W 7 Mile Rd, Detroit, MI 48219-2718 | 2007-04-11 |
| 1326168188 | Mary Ibe | Obstetrics & Gynecology | 3980 John R, Detroit, MI 48201 | 2007-03-29 |
| 1144365545 | George W Gibson | Obstetrics & Gynecology | 15201 W Mcnichols Rd, Detroit, MI 48235-3717 | 2007-02-21 |
| 1780764712 | Romeo H Tabbilos | Obstetrics & Gynecology | 3011 West Grand Boulevard, Suite 428, Detroit, MI 48202 | 2006-10-16 |
| 1497862189 | Terry A Wynn | Obstetrics & Gynecology | 14103 Fenkell St, Detroit, MI 48227-3214 | 2006-08-25 |
| 1104856897 | Ann R Gillett-elrington | Obstetrics & Gynecology | 13901 E Jefferson Ave, Detroit, MI 48215-2720 | 2006-07-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.