Individual
MR. GERALD ALBERT DE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
7860 RAEFORD RD, FAYETTEVILLE, NC 28304-6018
(910) 826-3582
Mailing address
7860 RAEFORD RD, FAYETTEVILLE, NC 28304-6018
(910) 826-3582
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10339
NC
Other
Enumeration date
04/14/2011
Last updated
04/14/2011
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