Basic Information
| Provider Information | |||||||||
| NPI: | 1194771063 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | URSIN | ||||||||
| FirstName: | GABRIELA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 N JUSTICE ST # 16 | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287913410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286948350 | ||||||||
| FaxNumber: | 8286947654 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 N JUSTICE ST | ||||||||
| Address2: | |||||||||
| City: | HENDERSONVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28791 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286961000 | ||||||||
| FaxNumber: | 8286961314 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 03/29/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 200300099 | NC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | PO1521622 | 01 | NC | RR MEDICARE | OTHER | P01146786 | 01 | NC | RR MEDICARE | OTHER | 89133UY | 05 | NC | MEDICAID | NC7042C | 01 | NC | MEDICARE PTAN | OTHER | 133UY | 01 | NC | BCBS NC | OTHER | 133UY | 01 | NC | BLUE CROSS | OTHER | P00310479 | 01 | NC | RAILROAD MEDICARE | OTHER |