Basic Information
| Provider Information | |||||||||
| NPI: | 1982637559 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CORBIE | ||||||||
| FirstName: | GISELLE | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CORBIE-SMITH | ||||||||
| OtherFirstName: | GISELLE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | UNC-CHAPEL HILL SCHOOL OF MEDICINE | ||||||||
| Address2: | 333 SOUTH COLUMBIA DEPARTMENT OF SOCIAL MEDICINE, CB#72 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199664996 | ||||||||
| FaxNumber: | 9198435515 | ||||||||
| Practice Location | |||||||||
| Address1: | UNC-CHAPEL HILL SCHOOL OF MEDICINE | ||||||||
| Address2: | 333 SOUTH COLUMBIA DEPARTMENT OF SOCIAL MEDICINE, CB#72 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27559 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199621136 | ||||||||
| FaxNumber: | 9198435515 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 07/27/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/27/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 200001291 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 89127PR | 05 | NC | MEDICAID |