Individual
GRACE MAYAMIKO JERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
91 ENTERPRISE DR, ROCKY MOUNT, NC 27804-9590
(252) 937-0235
(252) 937-3103
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 937-0200
(252) 451-0056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2008-00543
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150YG
BCBS OF NC
NC
01
—
212661
MEDCOST
NC
01
—
2587554
UNITED HEALTH CARE
NC
05
—
5910538
—
NC
01
—
6280481
AETNA
NC
01
—
7348979
CIGNA
NC
01
—
P00671247
RAILROAD MEDICARE
NC
Enumeration date
07/22/2005
Last updated
11/07/2023
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