Basic Information
| Provider Information | |||||||||
| NPI: | 1568787778 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEYER | ||||||||
| FirstName: | GABRIELA | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | RADUT | ||||||||
| OtherFirstName: | GABRIELA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | M.D. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 70 | ||||||||
| Address2: | |||||||||
| City: | LINCOLNTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280930070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047369188 | ||||||||
| FaxNumber: | 7047369667 | ||||||||
| Practice Location | |||||||||
| Address1: | 607 S GENERALS BLVD | ||||||||
| Address2: | |||||||||
| City: | LINCOLNTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280923658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7047369188 | ||||||||
| FaxNumber: | 7047369667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2010 | ||||||||
| LastUpdateDate: | 03/13/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 201401202 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | 201401202 | NC | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine |
No ID Information.