Provider Demographics
NPI:1134277866
Name:PULEO, JOEL GREGG (MD)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:GREGG
Last Name:PULEO
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 1:110 MEDICAL CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-5220
Mailing Address - Country:US
Mailing Address - Phone:910-410-9494
Mailing Address - Fax:910-410-9484
Practice Address - Street 1:110 MEDICAL CIRCLE
Practice Address - Street 2:
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-5220
Practice Address - Country:US
Practice Address - Phone:910-410-9494
Practice Address - Fax:910-410-9484
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC27965207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89014KGMedicaid
NC8911270Medicaid
NC203239CMedicare PIN
NC203239DMedicare PIN
NCC81737Medicare UPIN