MEDICARE: GREGORY G SMAROFF MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	2023-02926	NC
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	238560	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073581898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY G SMAROFF MD

Provider Business Mailing Address
First Line	:	PO BOX 68
Second Line	:
City	:	POLLOCKSVILLE
State	:	NC
Zip	:	28573-0068
Country	:	US
Telephone Number	:	252-633-6730
Fax Number	:	252-633-6740

Provider Business Practice Location Address
First Line	:	960 NEWMAN RD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5200
Country	:	US
Telephone Number	:	252-633-6730
Fax Number	:	252-633-6740

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	12/01/2023

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