Provider Demographics
NPI:1134134661
Name:GREB, LAWRENCE C (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:C
Last Name:GREB
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 1:60 MESSENGER ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02762-2258
Mailing Address - Country:US
Mailing Address - Phone:508-809-6379
Mailing Address - Fax:508-809-6365
Practice Address - Street 1:60 MESSENGER ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:MA
Practice Address - Zip Code:02762
Practice Address - Country:US
Practice Address - Phone:508-809-6379
Practice Address - Fax:508-809-6365
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55997207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0700906OtherUHC
405499OtherRIBCHIP
MA50150OtherFALLON
MA3091767Medicaid
MAJ05452OtherMABC
MA055997OtherTUFTS
MA13611OtherHPHC
MAB20143501OtherCIGNA
0700906OtherUHC
MA055997OtherTUFTS
MAJ05452OtherMABC