Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samantha Dare Gulledge, PA

Individual provider Physician Assistant · NPI 1740991504

Samantha Dare Gulledge, PA is a Physician Assistant in Wilmington, North Carolina. Qualified in 2022, 4 years ago. Practices with Southern Dermatology PA, a 51-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
4
Licensed in
NC
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1099 Medical Center Dr Suites 100 And 201
Wilmington, NC 28401
Phone: (910) 251-9994
Fax: (910) 763-4666
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 308 S Bennett St, Burgaw, NC 28425-5048 — (910) 251-9944
  • 720 Jefferson St, Whiteville, NC 28472-3706 — (910) 251-9944

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-12847 (NC)

Record details

NPI number1740991504
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 12, 2022
Last updated in NPPESMay 4, 2026
Certification dateMay 4, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Southern Dermatology Pa — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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