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NPI Code Detail

MEDICARE: DR. GREGG WAYNE MCANINCH M.D.

MEDICARE:  DR. GREGG WAYNE MCANINCH  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
12085R0202XDiagnostic Radiology PhysicianG64756CA
22085R0202XDiagnostic Radiology Physician7202NV
32085R0202XDiagnostic Radiology PhysicianMD00024407WA

General Provider Information

NPI Number : 1831105972
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GREGG WAYNE MCANINCH M.D.
Provider Business Mailing Address
First Line : PO BOX 2087
Second Line :
City : CARSON CITY
State : NV
Zip : 89702-2087
Country : US
Telephone Number : 775-888-1180
Fax Number : 775-852-6902
Provider Business Practice Location Address
First Line : 2874 N CARSON ST
Second Line : SUITE 215
City : CARSON CITY
State : NV
Zip : 89706-0251
Country : US
Telephone Number : 775-888-1180
Fax Number : 775-852-6902
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2006
Last Update Date : 09/18/2014

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Directions to “ DR. GREGG WAYNE MCANINCH M.D.” Practice Location

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