Provider Demographics
NPI:1679551980
Name:SINGLETON YATAWARA, GAYLE JENNETTE (MD)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:JENNETTE
Last Name:SINGLETON YATAWARA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 STATESVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2317
Mailing Address - Country:US
Mailing Address - Phone:704-754-8990
Mailing Address - Fax:704-754-8991
Practice Address - Street 1:415 STATESVILLE BLVD
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2317
Practice Address - Country:US
Practice Address - Phone:704-754-8990
Practice Address - Fax:704-754-8991
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9801060207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911241Medicaid
G80023Medicare UPIN
NC8911241Medicaid