MEDICARE: DR. DAVID S. GREGORY M.D.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101231022	VA

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	102874	OTHER	ANTHEM PROVIDER NUMBER
3	320665	OTHER	ANTHEM PROVIDER NUMBER
4	56-2559-9	OTHER	VA PREMIER PROVIDER NUMBE
5	41820	OTHER	SENTARA/OPTIMA PROVIDER N
6	541457983	OTHER	TRICARE PROVIDER NUMBER
7	56162	OTHER	MEDCOST PROVIDER NUMBER
8	248975	OTHER	SOUTHERN HEALTH PROVIDER
9	700011705	OTHER	CIGNA PROVIDER NUMBER
10	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
11	541457983	OTHER	PCHP PROVIDER NUMBER
12	5527697002	OTHER	CIGNA PROVIDER NUMBER

NPI Number	:	1275532921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID S. GREGORY M.D.

Provider Business Mailing Address
First Line	:	1314 PETERS CREEK RD NW
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24017-2500
Country	:	US
Telephone Number	:	540-562-5700
Fax Number	:	540-562-4278

Provider Business Practice Location Address
First Line	:	1314 PETERS CREEK RD NW
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24017-2500
Country	:	US
Telephone Number	:	540-562-5700
Fax Number	:	540-562-4278

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

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	12/28/2018

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax: