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NPI Code Detail

MEDICARE: DR. MARK M. MCGREGOR D.C.

MEDICARE: DR. MARK M. MCGREGOR D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NS0005XSports Physician Chiropractor1273MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AA1014OTHERMAHARVARD PILGRIM
2476767OTHERMAAETNA
3727382OTHERMATUFTS
4Y35910OTHERMABC/BS INDIVIDUAL
5Y39042OTHERMABC/BS GROUP

General Provider Information

NPI Number : 1952416414
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK M. MCGREGOR D.C.
Provider Business Mailing Address
First Line : 677 W MAIN ST
Second Line :
City : HYANNIS
State : MA
Zip : 02601-3493
Country : US
Telephone Number : 508-771-1115
Fax Number : 508-771-0655
Provider Business Practice Location Address
First Line : 677 W MAIN ST
Second Line :
City : HYANNIS
State : MA
Zip : 02601-3493
Country : US
Telephone Number : 508-771-1115
Fax Number : 508-771-0655
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 07/08/2007

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