Provider Demographics
NPI:1376327569
Name:ACREE, GREGORY JR
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:ACREE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-3735
Mailing Address - Country:US
Mailing Address - Phone:443-539-4897
Mailing Address - Fax:
Practice Address - Street 1:1817 E 31ST ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-3735
Practice Address - Country:US
Practice Address - Phone:443-539-4897
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory