Provider Demographics
NPI:1861442147
Name:SIMOLKE, GREGORY ALAN (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:ALAN
Last Name:SIMOLKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2209 S STERLING ST STE 400
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4092
Mailing Address - Country:US
Mailing Address - Phone:828-580-4661
Mailing Address - Fax:828-580-4698
Practice Address - Street 1:2293 SUGAR HILL RD STE C
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:NC
Practice Address - Zip Code:28752-7787
Practice Address - Country:US
Practice Address - Phone:828-652-3019
Practice Address - Fax:828-652-8001
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC35513207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8976339Medicaid
NC1790939320Medicaid
NC8976339Medicaid
NC2174646CMedicare PIN
NCF35052Medicare UPIN