Provider Demographics
NPI:1518930528
Name:GINGRICH, JEFFREY R (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:GINGRICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:40 DUKE MEDICAL CIR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-3006
Mailing Address - Country:US
Mailing Address - Phone:919-681-8760
Mailing Address - Fax:919-668-7093
Practice Address - Street 1:6301 HERNDON RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6315
Practice Address - Country:US
Practice Address - Phone:919-681-8760
Practice Address - Fax:919-668-7093
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NCMD421293208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001951620Medicaid
PA070469FKYMedicare ID - Type Unspecified
PA070469FKYMedicare PIN