Provider Demographics
NPI:1831136340
Name:REASH, GARY W (PA)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:W
Last Name:REASH
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:935 SHOTWELL RD
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520-5597
Mailing Address - Country:US
Mailing Address - Phone:919-550-0821
Mailing Address - Fax:919-719-3645
Practice Address - Street 1:1707 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-7345
Practice Address - Country:US
Practice Address - Phone:336-667-6363
Practice Address - Fax:336-667-8066
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2011-09-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8942015Medicaid
NC42015OtherBCBS
NC562261381COtherCIGNA
NC2799399DMedicare ID - Type Unspecified