Provider Demographics
NPI:1578743571
Name:GP MEDICAL CORPORATION
Entity Type:Organization
Organization Name:GP MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TURCI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-286-4270
Mailing Address - Street 1:1200 BROAD ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3579
Mailing Address - Country:US
Mailing Address - Phone:919-286-4270
Mailing Address - Fax:919-286-4546
Practice Address - Street 1:1200 BROAD ST
Practice Address - Street 2:SUITE 105
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3579
Practice Address - Country:US
Practice Address - Phone:919-286-4270
Practice Address - Fax:919-286-4546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36626302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7901966Medicaid
NC2326647Medicare PIN