Provider Demographics
NPI:1639143845
Name:GOLLEHON, DOUGLAS LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:LEE
Last Name:GOLLEHON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1120 SE CARY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7413
Mailing Address - Country:US
Mailing Address - Phone:919-467-4992
Mailing Address - Fax:919-481-9607
Practice Address - Street 1:1120 SE CARY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7413
Practice Address - Country:US
Practice Address - Phone:919-467-4992
Practice Address - Fax:919-481-9607
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2011-02-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC29277207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
4393368OtherAETNA PPO
2429303OtherUNITED HEALTHCARE
2077885OtherFIRST HEALTH
36164OtherBCBS
NC7936164Medicaid
2354647OtherAETNA HMO
2077885OtherFIRST HEALTH
A15978Medicare UPIN