| Samantha Dare Gulledge, PA | |
|
1099 Medical Center Dr, Suites 100 And 201, Wilmington, NC 28401 | |
| (910) 251-9994 | |
| (910) 763-4666 |
| Full Name | Samantha Dare Gulledge |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 1099 Medical Center Dr, Wilmington, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740991504 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-12847 (North Carolina) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern Dermatology Pa | 7012971609 | 52 |
| Entity Name | Charlotte Dermatology PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1265477251 PECOS PAC ID: 4486624590 Enrollment ID: O20040727001501 |
| Entity Name | Southern Dermatology PA |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568415586 PECOS PAC ID: 7012971609 Enrollment ID: O20041113000271 |
| Mailing Address | Practice Location Address |
|---|---|
| Samantha Dare Gulledge, PA Po Box 23329, New York, NY 10087-3329 Ph: Not Available | Samantha Dare Gulledge, PA 1099 Medical Center Dr, Suites 100 And 201, Wilmington, NC 28401 Ph: (910) 251-9994 |
Robin Elizabeth Jendrazak, OPA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2716 Ashton Dr, Wilmington, NC 28412 Phone: 910-332-3800 Fax: 910-332-3833 |
Grace Ellen Russell, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 120 Gazebo Ct, Wilmington, NC 28409 Phone: 910-264-9025 |
Crystal Dawn Hill, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2421 Silver Stream Ln, Wilmington, NC 28401 Phone: 910-341-3300 Fax: 910-251-8824 |
Rya Elisabeth Lawrence, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4402 Shipyard Blvd, Wilmington, NC 28403 Phone: 910-791-0075 Fax: 910-791-9674 |
Talia Francesca Marie Mcdonough, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1988 S 16th St, Wilmington, NC 28401 Phone: 910-662-8440 Fax: 910-795-4826 |
Hannah Salefsky, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6727 Parker Farm Dr, Wilmington, NC 28405 Phone: 910-772-0370 Fax: 910-256-5985 |
Mr. Grayson Brent Mayberry, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1415 Physicians Dr, Wilmington, NC 28401 Phone: 910-662-9500 Fax: 910-662-9501 |