Provider Demographics
NPI:1245222926
Name:HAWK, GREGOR M (MD)
Entity Type:Individual
Prefix:
First Name:GREGOR
Middle Name:M
Last Name:HAWK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 848269
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8269
Mailing Address - Country:US
Mailing Address - Phone:610-973-1700
Mailing Address - Fax:610-973-1778
Practice Address - Street 1:250 CETRONIA ROAD
Practice Address - Street 2:SUITE 303
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18106-9168
Practice Address - Country:US
Practice Address - Phone:610-973-6200
Practice Address - Fax:610-973-6546
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD066795L207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA029216OtherBLUE SHIELD
PA200035470OtherRAILROAD MEDICARE
821243OtherFIRST PRIORITY HEALTH
PA53818OtherGEISINGER
PA5667638001OtherCIGNA
PA5822550OtherAETNA
PAP1965619OtherOXFORD
PA029216OtherKEYSTONE CENTRAL
PA029216OtherAMERIHEALTH ADMIN
PA01199301OtherBLUE CROSS
PA0017300300001Medicaid
PA0205486000OtherKEYSTONE EAST
PA0017300300001Medicaid
PA019860Medicare PIN