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NPI Code Detail

MEDICARE: GREGG DAVID SCHUBACH M.D.

MEDICARE:   GREGG DAVID SCHUBACH  M.D.
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
1207UN0902XNuclear Imaging & Therapy PhysicianMD059410LPA
22085R0202XDiagnostic Radiology PhysicianMD059410LPA
32085R0202XDiagnostic Radiology Physician2022-01961NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MD059410LOTHERPALICENSE
225MA07565100OTHERNJLICENSE
3730893OTHERHIGHMARK
4188552-1OTHERNYLICENSE
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558369900
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGG DAVID SCHUBACH M.D.
Provider Business Mailing Address
First Line : PO BOX 30750
Second Line :
City : GREENVILLE
State : NC
Zip : 27833-0750
Country : US
Telephone Number : 252-931-7638
Fax Number : 252-931-7694
Provider Business Practice Location Address
First Line : 2101 W ARLINGTON BLVD STE 210
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-5758
Country : US
Telephone Number : 252-931-7638
Fax Number : 252-931-7694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2005
Last Update Date : 03/07/2023

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Directions to “ GREGG DAVID SCHUBACH M.D.” Practice Location

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