MR. GAVIN BLAIR GORE (NPI# 1316189608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316189608 |
| Entity Type | Individual |
| Full Name | MR. GAVIN BLAIR GORE |
| Practice Address |
1 Medical Center Boulevard Winston-salem NC 27103-2705 |
| Mailing Address |
125 Springhouse Farm Ct Winston Salem NC 27107-9809 |
| Practice Telephone | 3367166388 |
| Mailing Telephone | 4102512624 |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2015-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
2013-02510 | NC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1 MEDICAL CENTER BOULEVARD |
| City | WINSTON-SALEM |
| State | NC |
| Zip Code | 27103-2705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720598014 | Ronald Kyle Petersen | Nurse Anesthetist, Certified Registered | 1 Medical Center Boulevard, Winston-salem, NC 27103 | 2017-10-02 |
| 1083161632 | Amy Lynn Good | Nurse Anesthetist, Certified Registered | 1 Medical Center Boulevard, Winston-salem, NC 27103 | 2016-09-01 |
| 1174917165 | Charles Choi | Internal Medicine | 1 Medical Center Boulevard, Winston-salem, NC 27103 | 2015-03-27 |
| 1104231315 | Matylda Mazur | Student in an Organized Health Care Education/Training Program | 1 Medical Center Boulevard, Wake Forest Baptist Medical Center, Winston-salem, NC 27103-0001 | 2014-06-25 |
| 1134481260 | Teresa Clements Cunningham | Student in an Organized Health Care Education/Training Program | 1 Medical Center Boulevard, Winston-salem, NC 21757 | 2012-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346898632 | Mohamed Khalif Osman Warfa | Radiology | Diagnostic Radiology, Wake Forest School of Medicine, 1 Medical Boulevard, Winston-salem, NC 27157-0001 | 2019-08-29 |
| 1295997682 | Leslie Fort | Radiology | 3010 Trenwest Drive, Winston-salem, NC 27103-3208 | 2008-06-27 |
| 1851682165 | Megan Nancy Lee | Radiology | Medical Center Boulevard, North Carolina Baptist Hospital, Winston-salem, NC 27157 | 2011-04-21 |
| 1629148416 | David Dixon Childs | Radiology | Medical Center Blvd, Winston-salem, NC 27157-0001 | 2006-11-08 |
| 1316951874 | Eric Stuart Scharling | Radiology | 3155 Maplewood Avenue, Winston-salem, NC 27103 | 2006-07-28 |
| 1386679546 | Dennis Mark Clemens | Radiology | 3155 Maplewood Avenue, Winston-salem, NC 27103 | 2006-07-12 |
| 1043242019 | Thomas Holmes Hunt | Radiology | 3155 Maplewood Ave, Winston-salem, NC 27103 | 2006-07-07 |
| 1902837404 | Forsyth Radilogical Associates | Radiology | 3155 Maplewood Ave, Winston-salem, NC 27103-3903 | 2006-07-05 |
| 1780615187 | Liston Orr | Radiology | 3155 Maplewood Avenue, Winston-salem, NC 27103 | 2006-07-05 |
| 1376573816 | Andrew Mclean Dale | Radiology | 3155 Maplewood Ave, Winston-salem, NC 27103 | 2006-07-03 |
| Find all providers in WINSTON-SALEM | ||||
| City | WINSTON-SALEM |
| Zip Code | 27103 |
Please comment or provide details below to improve the information on MR. GAVIN BLAIR GORE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.