Individual
DR. GERALD BRUCE SIBRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 NAVAHO DRIVE, SUITE 105, RALEIGH, NC 27609
(919) 872-3851
Mailing address
1100 NAVAHO DRIVE, SUITE 105, RALEIGH, NC 27609
(919) 872-3851
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
24032
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76121
BLUE CROSS BLUE SHIELD
NC
05
—
8976121
—
NC
Enumeration date
02/21/2007
Last updated
07/08/2007
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