Provider Demographics
NPI:1285700625
Name:RESTREPO, GEORGE (DO)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:RESTREPO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 PROGRESS BLVD
Mailing Address - Street 2:
Mailing Address - City:SILER CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27344-6787
Mailing Address - Country:US
Mailing Address - Phone:919-799-4000
Mailing Address - Fax:919-799-4012
Practice Address - Street 1:475 PROGRESS BLVD
Practice Address - Street 2:
Practice Address - City:SILER CITY
Practice Address - State:NC
Practice Address - Zip Code:27344-6787
Practice Address - Country:US
Practice Address - Phone:919-799-4000
Practice Address - Fax:919-799-4012
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-01384207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D95435Medicare UPIN