Basic Information
| Provider Information | |||||||||
| NPI: | 1912402769 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAVINS | ||||||||
| FirstName: | GREGORY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2000 PERIMETER PARK DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | MORRISVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275608442 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 210 S CAMERON ST | ||||||||
| Address2: | |||||||||
| City: | HILLSBOROUGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272782505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9197329311 | ||||||||
| FaxNumber: | 9197329315 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2018 | ||||||||
| LastUpdateDate: | 09/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2021-00732 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.