Provider Demographics
NPI:1720151319
Name:GREGORY, GINGER DOBBINS (PA)
Entity Type:Individual
Prefix:
First Name:GINGER
Middle Name:DOBBINS
Last Name:GREGORY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-8901
Mailing Address - Country:US
Mailing Address - Phone:919-639-4266
Mailing Address - Fax:919-552-1495
Practice Address - Street 1:1418 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-8901
Practice Address - Country:US
Practice Address - Phone:919-552-1733
Practice Address - Fax:919-552-1495
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101410208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCR83424Medicare UPIN
NC2746535DMedicare PIN
NC2746535EMedicare PIN