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General NPI Number Information
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NPI Number | 1760611487
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Entity Type | Individual
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Provider Name | GRETCHEN MARIA INKUMSAH D.O.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 6801 FALLS OF NEUSE RD STE 401
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City | RALEIGH
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State | NC
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Zip | 27615-5325
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Country | US
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Telephone | 919-373-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 5045 NC HIGHWAY 42 W # B
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City | WILSON
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State | NC
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Zip | 27893-7731
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Country | US
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Telephone | 919-744-7793
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2012-01846
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License Number State | NC
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