Provider Demographics
NPI:1477768182
Name:BERTHOLD, GINA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIE
Last Name:BERTHOLD
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1202 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7307
Mailing Address - Country:US
Mailing Address - Phone:910-341-3300
Mailing Address - Fax:910-341-3321
Practice Address - Street 1:2421 SILVER STREAM LN
Practice Address - Street 2:ATTEN CREDENTIALING
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7684
Practice Address - Country:US
Practice Address - Phone:910-341-3300
Practice Address - Fax:910-341-3321
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2012-01777207RI0200X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases