Simala Young, Dawn Marie Gavagan
Simala Young, Dawn Marie Gavagan is an individual health care provider with primary practice located at 501 Olde Waterford Way , Leland NC 28451-4117. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Simala Young, Dawn Marie Gavagan can be contacted via phone (910) 408-1130.Contact Information
Primary practice address
501 Olde Waterford Way
Leland NC 28451-4117
Phone: (910) 408-1130
Fax: (910) 408-1135
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 02001458 | Indiana |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2022-02976 | North Carolina |
Profile Details
| NPI number | 1750368726 |
|---|---|
| LBN Legal business name | Simala Young, Dawn Marie Gavagan |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2005 |
| Last updated | Mar 15th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750368726 | NPPES |
| Indiana | Other | P01609365 | RR PTAN (MIAMI) |
| Indiana | MEDICAID | 100365980 | RR PTAN (MIAMI) |
| Indiana | Other | 000000984586 | RR PTAN (MIAMI) |
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