Provider Demographics
NPI:1891806378
Name:VALEROS, GAYLE DESIREE (MD)
Entity Type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:DESIREE
Last Name:VALEROS
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 1:63 MONTICELLO ROAD
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787
Mailing Address - Country:US
Mailing Address - Phone:828-645-3066
Mailing Address - Fax:828-658-3944
Practice Address - Street 1:50 SCHENCK PKWY
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3499
Practice Address - Country:US
Practice Address - Phone:828-213-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07130400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJH32750Medicare UPIN
NCNCJ806BMedicare PIN