Healthcare Provider Details

I. General information

NPI: 1477711067
Provider Name (Legal Business Name): MONICA ANNE MCGILL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS MONICA ANNE FILIPIAK

II. Dates (important events)

Enumeration Date: 05/30/2008
Last Update Date: 10/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2719 GRAVES DR SUITE 5
GOLDSBORO NC
27534-4536
US

IV. Provider business mailing address

2719 GRAVES DR SUITE 5
GOLDSBORO NC
27534-4536
US

V. Phone/Fax

Practice location:
  • Phone: 919-330-4367
  • Fax: 919-330-4375
Mailing address:
  • Phone: 919-330-4367
  • Fax: 919-330-4375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2012-01870
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: