Healthcare Provider Details

I. General information

NPI: 1699138529
Provider Name (Legal Business Name): ANTHONY JOSEPH GRECO III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8901 WISCONSIN AVE WALTER REED INTERNAL MEDICINE
BETHESDA MD
20889-0004
US

IV. Provider business mailing address

8901 WISCONSIN AVE WALTER REED INTERNAL MEDICINE
BETHESDA MD
20889-0004
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-0451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101262999
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: