Individual
MR. GREGORY THOMAS ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
PO BOX 936857, ATLANTA, GA 31193-6857
(910) 662-9500
(910) 662-9501
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5005436
NC
363LA2200X
Adult Health Nurse Practitioner
5005436
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033487806
—
NC
Enumeration date
12/08/2011
Last updated
07/29/2024
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