Provider Demographics
NPI:1134119738
Name:FINK, GARY LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:LEE
Last Name:FINK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:611 MOCKSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2705
Mailing Address - Country:US
Mailing Address - Phone:704-633-7220
Mailing Address - Fax:704-647-0515
Practice Address - Street 1:1000 BROWN ST
Practice Address - Street 2:
Practice Address - City:FAITH
Practice Address - State:NC
Practice Address - Zip Code:28041
Practice Address - Country:US
Practice Address - Phone:704-633-7220
Practice Address - Fax:704-647-0515
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC28409207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8932047Medicaid
NC203747CMedicare PIN