Provider Demographics
NPI:1811995251
Name:SCHIMIZZI, GREGORY F (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:F
Last Name:SCHIMIZZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1710 S. 17TH ST.
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6442
Mailing Address - Country:US
Mailing Address - Phone:910-762-1182
Mailing Address - Fax:910-332-1111
Practice Address - Street 1:1710 S. 17TH ST.
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6442
Practice Address - Country:US
Practice Address - Phone:910-762-1182
Practice Address - Fax:910-332-1111
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC31902207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC897489AMedicaid
NC897489AMedicaid
210205BMedicare PIN
NCB49410Medicare UPIN
B49410Medicare UPIN
NC1277990001Medicare NSC