MEDICARE: DR. GREGG C DONALDSON 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	207R00000X	Internal Medicine Physician	D0042054	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	990015534	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	893415	OTHER	MDIPA/OPTIMUM CHOICE
3	W3990008	OTHER	BCBS FEDERAL
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	2100999	OTHER	UNITED HEALTHCARE
8	2117570	OTHER	CIGNA
9	528302-02	OTHER	BCBS POS
10	P14964	OTHER	BCBS POS PRIMARY

General Provider Information

NPI Number	:	1114920576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGG C DONALDSON MD

Provider Business Mailing Address
First Line	:	912 SETON DR
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-1818
Country	:	US
Telephone Number	:	301-722-3111
Fax Number	:	301-722-5135

Provider Business Practice Location Address
First Line	:	912 SETON DR
Second Line	:
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-1818
Country	:	US
Telephone Number	:	301-722-3111
Fax Number	:	301-722-5135

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	02/04/2013

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Directions to “ DR. GREGG C DONALDSON MD” Practice Location

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