Provider Demographics
NPI:1497969927
Name:FOLGER, GORDON WILKINSON (MAED)
Entity Type:Individual
Prefix:MS
First Name:GORDON
Middle Name:WILKINSON
Last Name:FOLGER
Suffix:
Gender:F
Credentials:MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HILLCREST RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1719
Mailing Address - Country:US
Mailing Address - Phone:919-833-3353
Mailing Address - Fax:
Practice Address - Street 1:203 HILLCREST RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1719
Practice Address - Country:US
Practice Address - Phone:919-833-3353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC397174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist