Healthcare Provider Details

I. General information

NPI: 1982308292
Provider Name (Legal Business Name): GILLIAN AINSLEY GARDINER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 W D ST
NORTH WILKESBORO NC
28659-3506
US

IV. Provider business mailing address

MEDICAL CENTER BOULEVARD GROUND FLOOR MEADS HALL SUITE B
WINSTON SALEM NC
27157-0001
US

V. Phone/Fax

Practice location:
  • Phone: 336-651-8100
  • Fax: 336-651-8465
Mailing address:
  • Phone: 336-716-6410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2026-02504
License Number StateNC
# 2
Primary TaxonomyN
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: