MEDICARE: DR. GREGORY D CASEY 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	2086S0127X	Trauma Surgery Physician	3035	VI
2	2086S0127X	Trauma Surgery Physician	4301050406	MI
3	2086S0129X	Vascular Surgery Physician	3035	VI
4	208600000X	Surgery Physician	3035	VI
5	2086S0102X	Surgical Critical Care Physician	4301050406	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0B56029	OTHER	MI	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487604260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY D CASEY MD

Provider Business Mailing Address
First Line	:	PO BOX 5975
Second Line	:
City	:	CHRISTIANSTED
State	:	VI
Zip	:	00823-5975
Country	:	US
Telephone Number	:	517-937-1661
Fax Number	:

Provider Business Practice Location Address
First Line	:	4007 ESTATE DIAMOND RUBY
Second Line	:
City	:	ST CROIX
State	:	VI
Zip	:	00820-4435
Country	:	US
Telephone Number	:	340-778-6311
Fax Number	:

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	02/07/2023

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Directions to “ DR. GREGORY D CASEY MD” Practice Location

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