Provider Demographics
NPI:1568011609
Name:BYNUM, GAY Y
Entity Type:Individual
Prefix:MRS
First Name:GAY
Middle Name:Y
Last Name:BYNUM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7734 GOLDSTON GLENDON RD
Mailing Address - Street 2:
Mailing Address - City:GOLDSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27252
Mailing Address - Country:US
Mailing Address - Phone:910-464-2383
Mailing Address - Fax:
Practice Address - Street 1:7734 GOLDSTON GLENDON RD
Practice Address - Street 2:
Practice Address - City:GOLDSTON
Practice Address - State:NC
Practice Address - Zip Code:27252
Practice Address - Country:US
Practice Address - Phone:910-464-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider