MEDICARE: GLORIA VREELAND M.D.

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	207Q00000X	Family Medicine Physician	0401000	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00184032	OTHER	NC	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	137HJ	OTHER	NC	BCBS NC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770684292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA VREELAND M.D.

Provider Business Mailing Address
First Line	:	1333 S DICKINSON DR
Second Line	:	#140
City	:	LELAND
State	:	NC
Zip	:	28451-6430
Country	:	US
Telephone Number	:	910-371-0404
Fax Number	:	910-371-1005

Provider Business Practice Location Address
First Line	:	1333 S DICKINSON DR
Second Line	:
City	:	LELAND
State	:	NC
Zip	:	28451-6430
Country	:	US
Telephone Number	:	910-371-0404
Fax Number	:	910-371-1005

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	10/31/2014

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Directions to “ GLORIA VREELAND M.D.” Practice Location

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