Healthcare Provider Details

I. General information

NPI: 1306586136
Provider Name (Legal Business Name): CAROLINE GERHARDT SAMUELS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CAROLINE ANNE GERHARDT MD

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 DUKE MEDICINE CIR # 3K
DURHAM NC
27710-4000
US

IV. Provider business mailing address

3217 STAR GAZING LN
DURHAM NC
27703-6850
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-3432
  • Fax:
Mailing address:
  • Phone: 919-684-3432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: