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1184608572

NPI Code Detail

MEDICARE: GREGORY JAY POMPER MD

MEDICARE: GREGORY JAY POMPER 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	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	200101386	NC
2	207ZB0001X	Blood Banking & Transfusion Medicine Physician	96497	SC
3	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	96497	SC
4	207ZB0001X	Blood Banking & Transfusion Medicine Physician	200101386	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	220032248	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	130JP	OTHER		BCBS
2	B3047	OTHER		MEDCOST
3	46203	OTHER		PARTNERS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	7953351	OTHER		AETNA

General Provider Information

NPI Number	:	1184608572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY JAY POMPER MD

Provider Business Mailing Address
First Line	:	PO BOX 751461
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1461
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 ASHLEY AVE
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-0100
Country	:	US
Telephone Number	:	843-792-1414
Fax Number	:

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

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	03/11/2026

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Directions to “ GREGORY JAY POMPER MD” Practice Location

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