Individual
GERALD ANTHONY MACCIOLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 WAKE FOREST RD, RALEIGH, NC 27609-7317
(919) 954-3765
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 873-9533
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
29769
NC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
29769
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050011528
RAILROAD-MEDICARE
NC
01
—
132EW
BCBS NC
NC
01
—
24432
PARTNERS
NC
01
—
57292
MEDCOST
NC
01
—
6715051
CIGNA
NC
05
—
89132EW
—
NC
Enumeration date
08/31/2006
Last updated
04/03/2015
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