Individual
DR. SIDNEY LOY GULLEDGE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4301 LAKE BOONE TRL, STE 200, RALEIGH, NC 27607-7507
(919) 782-5210
Mailing address
4301 LAKE BOONE TRL, STE 200, RALEIGH, NC 27607-7507
(919) 782-5210
(919) 784-3384
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20908
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8937876
—
NC
Enumeration date
01/26/2006
Last updated
07/08/2007
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