Provider Demographics
NPI:1356482640
Name:MATTSON, GERRI LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:GERRI
Middle Name:LYNN
Last Name:MATTSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GERRI
Other - Middle Name:LYNN
Other - Last Name:FINKELSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:402 STONEHILL RD
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-8638
Mailing Address - Country:US
Mailing Address - Phone:919-933-9816
Mailing Address - Fax:919-870-4881
Practice Address - Street 1:10 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1808
Practice Address - Country:US
Practice Address - Phone:919-250-4570
Practice Address - Fax:919-250-4581
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9900930208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCG95746Medicare UPIN