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NPI Code Detail

MEDICARE: GREGORY D GREEK MD

MEDICARE: GREGORY D GREEK 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
1207Q00000XFamily Medicine Physician5362ND

General Provider Information

NPI Number : 1376634386
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY D GREEK MD
Provider Business Mailing Address
First Line : PO BOX 6002
Second Line :
City : GRAND FORKS
State : ND
Zip : 58206-6002
Country : US
Telephone Number : 701-780-5000
Fax Number :
Provider Business Practice Location Address
First Line : 725 HAMLINE ST
Second Line :
City : GRAND FORKS
State : ND
Zip : 58203-2819
Country : US
Telephone Number : 701-777-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 10/12/2020

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Directions to “ GREGORY D GREEK MD” Practice Location

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