Basic Information
| Provider Information | |||||||||
| NPI: | 1003006149 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GAMBOA | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | H | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., M.P.H. | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF NORTH CAROLINA | ||||||||
| Address2: | 590 MANNING DR, CB #7595 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199662236 | ||||||||
| FaxNumber: | 9199666125 | ||||||||
| Practice Location | |||||||||
| Address1: | UNC DEPT OF FAMILY MEDICINE | ||||||||
| Address2: | 590 MANNING DR, CB #7595 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199662236 | ||||||||
| FaxNumber: | 9199666125 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2007 | ||||||||
| LastUpdateDate: | 12/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | A93276 | CA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 232725 | MA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2008-01775 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.