Healthcare Provider Details

I. General information

NPI: 1457578023
Provider Name (Legal Business Name): NANCY M. MCGREAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TRENT DRIVE DUMC 3913
DURHAM NC
27710
US

IV. Provider business mailing address

200 TRENT DRIVE DUMC 3913
DURHAM NC
27710
US

V. Phone/Fax

Practice location:
  • Phone: 919-684-1817
  • Fax: 919-681-8147
Mailing address:
  • Phone: 919-684-1817
  • Fax: 919-681-8147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License Number2009-1439
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2009-01439
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: