Healthcare Provider Details

I. General information

NPI: 1003731969
Provider Name (Legal Business Name): MADISON MICHELLE GILDER DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 ORCHARD VILLAS AVE
APEX NC
27502-4321
US

IV. Provider business mailing address

5711 CLEARBAY LN
RALEIGH NC
27612-8601
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-2445
  • Fax:
Mailing address:
  • Phone: 704-526-5478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP25148
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: