Provider Demographics
NPI:1487639928
Name:GREGOR, HENRY FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:FREDERICK
Last Name:GREGOR
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:PO BOX 2018
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-2018
Mailing Address - Country:US
Mailing Address - Phone:828-553-1951
Mailing Address - Fax:
Practice Address - Street 1:510 S SOUTH ST
Practice Address - Street 2:
Practice Address - City:MOUNT AIRY
Practice Address - State:NC
Practice Address - Zip Code:27030
Practice Address - Country:US
Practice Address - Phone:336-786-4522
Practice Address - Fax:336-789-3025
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01051269A207V00000X
NC33834207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200973290Medicaid
NC8937129Medicaid
IN000000639417OtherANTHEM PROVIDER NUMBER
NC37129OtherBCBS
SCN33834Medicaid
SCN33834Medicaid
NC8937129Medicaid
BO7676Medicare UPIN
IN200973290Medicaid