Provider Demographics
NPI:1033105507
Name:GEBRAIL, AYMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AYMAN
Middle Name:
Last Name:GEBRAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2032 S 17TH ST
Mailing Address - Street 2:STE 101
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6677
Mailing Address - Country:US
Mailing Address - Phone:910-763-3738
Mailing Address - Fax:910-763-0454
Practice Address - Street 1:2032 SOUTH 17TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6678
Practice Address - Country:US
Practice Address - Phone:910-763-3738
Practice Address - Fax:910-763-0454
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200100874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89129GHMedicaid
2287359BMedicare PIN
NC89129GHMedicaid