Provider Demographics
NPI:1235334046
Name:IVEY, NOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:NOEL
Middle Name:
Last Name:IVEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:NOEL
Other - Last Name:MCFADDEN-GERBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 DUKE MEDICINE CIRCLE BOX 3534
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-681-8263
Mailing Address - Fax:919-668-5394
Practice Address - Street 1:2310 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-2576
Practice Address - Country:US
Practice Address - Phone:919-681-8263
Practice Address - Fax:919-668-5394
Is Sole Proprietor?:No
Enumeration Date:2007-06-20
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201000768207R00000X
ORLL18759207R00000X
OR390200000X
NC2010-00768207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program