Provider Demographics
NPI:1962166207
Name:GAM-MED PLLC
Entity type:Organization
Organization Name:GAM-MED PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHEIK
Authorized Official - Middle Name:AMAT TIJAN
Authorized Official - Last Name:FAYE
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:857-206-4067
Mailing Address - Street 1:101 FOY DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2418
Mailing Address - Country:US
Mailing Address - Phone:252-443-6440
Mailing Address - Fax:252-443-6442
Practice Address - Street 1:101 FOY DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2418
Practice Address - Country:US
Practice Address - Phone:252-443-5723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health