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NPI Code Detail

MEDICARE: DR. GREGORY J ALBA D.O.

MEDICARE: DR. GREGORY J ALBA D.O.
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 Physician0102201115VA

General Provider Information

NPI Number : 1497752505
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGORY J ALBA D.O.
Provider Business Mailing Address
First Line : 1204 FENWICK DR
Second Line :
City : LYNCHBURG
State : VA
Zip : 24502-2112
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 130 ENTERPRISE DR
Second Line :
City : DANVILLE
State : VA
Zip : 24540-4070
Country : US
Telephone Number : 434-791-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 10/21/2011

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