Healthcare Provider Details

I. General information

NPI: 1275504243
Provider Name (Legal Business Name): TONYA T GILBERT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 WAKE FOREST RD # 349
RALEIGH NC
27609-0010
US

IV. Provider business mailing address

4504 ALEXANDER VALLEY DR APT 202
CHARLOTTE NC
28270-1510
US

V. Phone/Fax

Practice location:
  • Phone: 980-221-7944
  • Fax:
Mailing address:
  • Phone: 910-705-6102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMG134090
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA050618
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-01792
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: