Healthcare Provider Details

I. General information

NPI: 1093746570
Provider Name (Legal Business Name): ALISON P GUPTILL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALISON ERIN PRESTIA

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11200 GOVERNOR MANLY WAY SUITE 205
RALEIGH NC
27614-6830
US

IV. Provider business mailing address

1600 PERIMETER PARK DR SUITE 225
MORRISVILLE NC
27560-8421
US

V. Phone/Fax

Practice location:
  • Phone: 919-570-7700
  • Fax: 919-570-7701
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200600437
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: