Provider Demographics
NPI:1235231762
Name:ARCHINAL, GINETTE ANNE (MD)
Entity Type:Individual
Prefix:
First Name:GINETTE
Middle Name:ANNE
Last Name:ARCHINAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SW CARY PKWY
Mailing Address - Street 2:# 170
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5562
Mailing Address - Country:US
Mailing Address - Phone:919-467-5678
Mailing Address - Fax:919-467-1948
Practice Address - Street 1:101 SW CARY PKWY
Practice Address - Street 2:# 170
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5562
Practice Address - Country:US
Practice Address - Phone:919-467-5678
Practice Address - Fax:919-467-1948
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC98-00768207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89013HVMedicaid
NC2260152AMedicare ID - Type Unspecified
NCG82189Medicare UPIN