Basic Information
| Provider Information | |||||||||
| NPI: | 1205361482 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILL | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | OCHS | ||||||||
| OtherFirstName: | KATHERINE | ||||||||
| OtherMiddleName: | NICOLE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | AMBULATORY CARE CTR | ||||||||
| Address2: | 102 MASON FARM RD. | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199661459 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | AMBULATORY CARE CTR | ||||||||
| Address2: | 102 MASON FARM RD. | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199661459 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2017 | ||||||||
| LastUpdateDate: | 01/05/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 227789 | NC | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 227789 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.