Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mary Roxanne Gillam, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1578143608

Mary Roxanne Gillam, DO is a Student in an Organized Health Care Education/Training Program in Royal Oak, Michigan. Works from 2 locations. Licensed in Michigan.

Licensed in
MI
In the registry since
2021
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone: (248) 898-0727
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6655 S Cimarron Rd Ste 100, Las Vegas, NV 89113-2181 — (702) 853-3561

Specialties & licences

Pediatric Emergency Medicine (Emergency Medicine) Physician (primary) Taxonomy 207PP0204X · Licence 5101027958 (MI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1578143608
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 13, 2021
Last updated in NPPESJanuary 28, 2025
Certification dateJanuary 28, 2025

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