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General NPI Number Information
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NPI Number | 1801079173
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Entity Type | Organization
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Legal Business Name | ROBERT G. MCGREEVY MD, PC
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Dates
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Enumeration Date | 12/10/2007
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Last Update Date | 12/10/2007
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Provider Practice Location Address
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Address Line | 1371 N 10TH AVE
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City | STAYTON
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State | OR
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Zip | 97383-2037
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Country | US
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Telephone | 503-769-3785
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Fax | 503-769-3741
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Provider Business Mailing Address
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Address Line | 1371 N 10TH AVE
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City | STAYTON
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State | OR
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Zip | 97383-2037
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Country | US
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Telephone | 503-769-3785
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Fax | 503-769-3741
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT G MCGREEVY
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Credential | MD
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Telephone | 503-769-3785
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD17836
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License Number State | OR
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