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NPI Code Detail

MEDICARE: DR. VICTOR MARCEL GELLINEAU III M.D.

MEDICARE:  DR. VICTOR MARCEL GELLINEAU III M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2021-02186NC
2207Q00000XFamily Medicine PhysicianA75952CA

General Provider Information

NPI Number : 1184794331
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. VICTOR MARCEL GELLINEAU III M.D.
Provider Business Mailing Address
First Line : PO BOX 746724
Second Line :
City : ATLANTA
State : GA
Zip : 30374-6724
Country : US
Telephone Number : 312-733-9730
Fax Number : 773-866-8014
Provider Business Practice Location Address
First Line : 4600 CAPITAL BLVD
Second Line :
City : RALEIGH
State : NC
Zip : 27604-4478
Country : US
Telephone Number : 919-980-7008
Fax Number : 919-336-4528
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2006
Last Update Date : 09/14/2021

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