Michael D Gillum, MD

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

MD00025477 Issued in WA

Practice address

624 E Front Ave
Spokane, WA 99202-2139

Phone

(509) 626-9904

NPI assigned

Jun 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inland Empire Hospital Services Association

  dba Family Medicine of Spokane

  • Family Medicine Physician
  • Spokane, WA
  • NPI 1326002163
  NPD (past)
• Physicians Clinic of Spokane PS

  • Multi-Specialty Clinic/Center
  • Spokane, WA
  • NPI 1336186105
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1730122276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 421",
            "address_2": "STE 200",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190421",
            "telephone_number": "509-474-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 E FRONT AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022139",
            "telephone_number": "509-626-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLUM",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD00025477",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgillum327411@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "624 E Front Ave",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992022139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anne Kayla Gillette, MS, LMHC-A, LPC, NCC
• Gilliam Endodontics, PLLC
• Jayme Kristina Gilliam, MOTR/L, CHT
• George A Gillis, LICENSED PRACTICAL N
• Leigh Gilliver, PA
• Shannon Gilman, BEHAVIOR SUPPORT
• Emily Gabrielle Gilmartin
• John Spencer Gilmer, MD
• Aubrey Gilmore
• Cara Gilmore, PT, DPT

• Infectious Disease Physician in Spokane, WA
• Providers in Spokane, WA by specialty
• Infectious Disease Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.