Provider Demographics
NPI:1528878469
Name:HASKELL, GLORIA THOMPSON (PHD, FACMG)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:THOMPSON
Last Name:HASKELL
Suffix:
Gender:F
Credentials:PHD, FACMG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 YORK CT
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-3394
Mailing Address - Country:US
Mailing Address - Phone:336-436-1275
Mailing Address - Fax:
Practice Address - Street 1:1440 YORK CT
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-3394
Practice Address - Country:US
Practice Address - Phone:336-436-1275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017093207SC0300X
NC2019115207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics
No207SC0300XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Cytogenetics