Organization
GINGRAS SLEEP MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEANNINE LOUISE GINGRAS MD (OWNER)
(704) 944-0562
Entity
Organization
Contact information
Practice address
6207 PARK SOUTH DR, SUITE 101, CHARLOTTE, NC 28210-3267
(704) 944-0562
(704) 944-0563
Mailing address
6207 PARK SOUTH DR, SUITE 101, CHARLOTTE, NC 28210-3267
(704) 944-0562
(704) 944-0563
Taxonomy
Speciality
Code
Description
License number
State
2080S0012X
Pediatric Sleep Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
023N8
BCBS
NC
05
—
5915209
—
NC
01
—
DR3092
RAILROAD MEDICARE
NC
05
—
NPB395
—
SC
Enumeration date
07/22/2010
Last updated
08/11/2011
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