Provider Demographics
NPI:1073807178
Name:WURL, GREGORY M (RPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:M
Last Name:WURL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:479 STATE RD
Mailing Address - Street 2:T-2167
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-4309
Mailing Address - Country:US
Mailing Address - Phone:508-979-7531
Mailing Address - Fax:508-979-7536
Practice Address - Street 1:479 STATE RD
Practice Address - Street 2:T-2167
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-4309
Practice Address - Country:US
Practice Address - Phone:508-979-7531
Practice Address - Fax:508-979-7536
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH22916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist