Healthcare Provider Details

I. General information

NPI: 1417986266
Provider Name (Legal Business Name): GERARD A MCCALL M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 02/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9458
US

IV. Provider business mailing address

2707 MEDICAL OFFICE PL
GOLDSBORO NC
27534-9458
US

V. Phone/Fax

Practice location:
  • Phone: 919-735-9146
  • Fax: 919-735-0582
Mailing address:
  • Phone: 919-735-9146
  • Fax: 919-735-0582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number1016
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: