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Individual

DR. JERRY SHUMATE ALVIS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S., P.A.

Contact information

Practice address
5603 DURALEIGH RD, SUITE 131, RALEIGH, NC 27612-2688
(919) 782-5752
(919) 782-5797
Mailing address
5603 DURALEIGH RD, SUITE 131, RALEIGH, NC 27612-2688
(919) 782-5752
(919) 782-5797

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6792
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1455728
UNITED CONCORDIA
NC
01
90065
BCBS
NC
Enumeration date
06/20/2006
Last updated
07/08/2007
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