Provider Demographics
NPI:1013030675
Name:GRAVELLE-CAMELO, SHERYL LYNN (MD)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:LYNN
Last Name:GRAVELLE-CAMELO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:HOPE MILLS
Mailing Address - State:NC
Mailing Address - Zip Code:28348-0647
Mailing Address - Country:US
Mailing Address - Phone:910-483-7337
Mailing Address - Fax:910-483-0648
Practice Address - Street 1:427 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-2580
Practice Address - Country:US
Practice Address - Phone:828-524-7337
Practice Address - Fax:828-369-1340
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400065208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1563736OtherCOVENTRY OF THE CAROLINAS
NC295815OtherMEDCOST, LLC
NCFH1101845OtherFIRST CAROLINA CARE
NC38614OtherBCBS OF NC
NC89133PKMedicaid
NC5429653OtherCIGNA/GREATWEST
NC1013030675OtherHEALTHNET FEDERAL SERVICES
NC1013030675OtherHEALTHSMART
NC1013030675Medicaid
NC1294636OtherUNITED HEALTHCARE
NC1563736OtherWELLPATH
NC4596541OtherCOVENTRY NATIONAL - COVENTRY PPO
NC1013030675OtherDOCTORS DIRECT
NC1013030675OtherHUMANA
NC12350463OtherPHCS/MULTIPLAN
NC5380016OtherAETNA
NC1013030675Medicaid