Healthcare Provider Details

I. General information

NPI: 1225290752
Provider Name (Legal Business Name): ANDRE NICOLAS GAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N JUSTICE ST
HENDERSONVILLE NC
28791-3518
US

IV. Provider business mailing address

800 N JUSTICE ST
HENDERSONVILLE NC
28791-3518
US

V. Phone/Fax

Practice location:
  • Phone: 510-309-7736
  • Fax:
Mailing address:
  • Phone: 510-309-7736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA126102
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number2025-00786
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: