Provider Demographics
NPI:1578813275
Name:GERALD, ANTHONY BERNARD (RRT,RCP)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:BERNARD
Last Name:GERALD
Suffix:
Gender:M
Credentials:RRT,RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 S RAEFORD RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-6162
Mailing Address - Country:US
Mailing Address - Phone:910-475-6421
Mailing Address - Fax:910-867-8343
Practice Address - Street 1:7300 S RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-6162
Practice Address - Country:US
Practice Address - Phone:910-475-6421
Practice Address - Fax:910-867-8343
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-11
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6308227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredGroup - Single Specialty