Healthcare Provider Details

I. General information

NPI: 1013310457
Provider Name (Legal Business Name): RAGHUBINDER S GILL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2014
Last Update Date: 09/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR DUKE CLINIC 2H
DURHAM NC
27710-4000
US

IV. Provider business mailing address

PO BOX 63362
CHARLOTTE NC
28263-3362
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-2661
  • Fax: 919-681-8147
Mailing address:
  • Phone: 919-684-2661
  • Fax: 919-681-8147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2014-01303
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: