=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508397696
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSEPH MICHAEL GRESCHNER D.P.M
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2017
-----------------------------------------------------
Last Update Date | 11/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 HOSPITAL PLZ
-----------------------------------------------------
City | GRAFTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26354-1283
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-265-0400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 511 BURROUGHS ST STE 101
-----------------------------------------------------
City | MORGANTOWN
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26505-3389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-974-0317
-----------------------------------------------------
Fax | 304-892-8790
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number | 10493
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------