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Individual

MR. HENRY WILSON VAN GILS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 231-6333
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11041
NC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1326646597
NC
Enumeration date
10/11/2020
Last updated
10/25/2022
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