Physician Compare National (NPI:1699733782)

HEALTHCARE PROVIDER: GREGORY C BOLTON JR. MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1699733782
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911990650
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050627000053
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOLTON
	Individual professional last name
Provider First Name	GREGORY
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	TEMPLE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4092 SKIPPACK PIKE
	Group Practice or individual's line 1 address
Line 2 Street Address	MAXIMUM WELLNESS MD
	Group Practice or individual's line 2 address
City	SKIPPACK
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	194740195
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	READING HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y