Provider Demographics
NPI:1245223494
Name:GREGG, BARBARA F (CFNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:F
Last Name:GREGG
Suffix:
Gender:F
Credentials:CFNP
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 118008
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29423-8008
Mailing Address - Country:US
Mailing Address - Phone:843-567-3206
Mailing Address - Fax:843-567-6287
Practice Address - Street 1:104 FUNK AVE
Practice Address - Street 2:
Practice Address - City:SAINT STEPHEN
Practice Address - State:SC
Practice Address - Zip Code:29479-3383
Practice Address - Country:US
Practice Address - Phone:843-567-3206
Practice Address - Fax:843-567-3287
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF2390207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP0061Medicaid
SCP00928291OtherRR MEDICARE
Q31363Medicare UPIN
SCAA51697819Medicare PIN