Provider Demographics
NPI:1073581898
Name:SMAROFF, GREGORY G (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:G
Last Name:SMAROFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:POLLOCKSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28573-0068
Mailing Address - Country:US
Mailing Address - Phone:252-633-6730
Mailing Address - Fax:252-633-6740
Practice Address - Street 1:960 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-5200
Practice Address - Country:US
Practice Address - Phone:252-633-6730
Practice Address - Fax:252-633-6740
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2023-02926208G00000X
MA238560208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110082075AMedicaid
MA110082075AMedicaid
MA001032401Medicare PIN