Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 9400065 | NC |
NPI | 1013030675 |
---|---|
Provider Name | Sheryl Lynn Gravelle-Camelo |
First Address | Hope Mills, NC 28348-0647 |
Second Address | Franklin, NC 28734-2580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 03/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013030675 | (05) | NC |
1013030675 | DOCTORS DIRECT (01) | NC |
1013030675 | HEALTHNET FEDERAL SERVICES (01) | NC |
1013030675 | HEALTHSMART (01) | NC |
1013030675 | HUMANA (01) | NC |
12350463 | PHCS/MULTIPLAN (01) | NC |
1294636 | UNITED HEALTHCARE (01) | NC |
1563736 | COVENTRY OF THE CAROLINAS (01) | NC |
1563736 | WELLPATH (01) | NC |
295815 | MEDCOST, LLC (01) | NC |
38614 | BCBS OF NC (01) | NC |
4596541 | COVENTRY NATIONAL - COVENTRY PPO (01) | NC |
5380016 | AETNA (01) | NC |
5429653 | CIGNA/GREATWEST (01) | NC |
89133PK | (05) | NC |
F95671 | (02) | NC |
FH1101845 | FIRST CAROLINA CARE (01) | NC |