Healthcare Provider Details

I. General information

NPI: 1316181852
Provider Name (Legal Business Name): LAUREN GREGG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 01/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 ATLEE RD MEMORIAL REGIONAL MEDICAL CENTER
MECHANICSVILLE VA
23116-1844
US

IV. Provider business mailing address

38935 ANN ARBOR RD ONE HAMPTON MEDICAL, LLC
LIVONIA MI
48150-3397
US

V. Phone/Fax

Practice location:
  • Phone: 804-569-7007
  • Fax: 804-569-1772
Mailing address:
  • Phone: 888-861-8740
  • Fax: 866-250-6385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number0101254566
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: