MEDICARE: SHERYL LYNN GRAVELLE-CAMELO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	9400065	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1563736	OTHER	NC	COVENTRY OF THE CAROLINAS
2	295815	OTHER	NC	MEDCOST, LLC
3	FH1101845	OTHER	NC	FIRST CAROLINA CARE
4	38614	OTHER	NC	BCBS OF NC
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	5429653	OTHER	NC	CIGNA/GREATWEST
7	1013030675	OTHER	NC	HEALTHNET FEDERAL SERVICES
8	1013030675	OTHER	NC	HEALTHSMART
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
10	1294636	OTHER	NC	UNITED HEALTHCARE
11	1563736	OTHER	NC	WELLPATH
12	4596541	OTHER	NC	COVENTRY NATIONAL - COVENTRY PPO
13	1013030675	OTHER	NC	DOCTORS DIRECT
14	1013030675	OTHER	NC	HUMANA
15	12350463	OTHER	NC	PHCS/MULTIPLAN
16	5380016	OTHER	NC	AETNA

General Provider Information

NPI Number	:	1013030675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERYL LYNN GRAVELLE-CAMELO MD

Provider Business Mailing Address
First Line	:	PO BOX 647
Second Line	:
City	:	HOPE MILLS
State	:	NC
Zip	:	28348-0647
Country	:	US
Telephone Number	:	910-483-7337
Fax Number	:	910-483-0648

Provider Business Practice Location Address
First Line	:	427 HARRISON AVE
Second Line	:
City	:	FRANKLIN
State	:	NC
Zip	:	28734-2580
Country	:	US
Telephone Number	:	828-524-7337
Fax Number	:	828-369-1340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	06/03/2016

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