Provider Demographics
NPI:1659352375
Name:GRECO, JOHN JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:GRECO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 2415
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21802-2415
Mailing Address - Country:US
Mailing Address - Phone:410-749-4154
Mailing Address - Fax:140-860-9583
Practice Address - Street 1:1675 WOODBROOKE DRIVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804
Practice Address - Country:US
Practice Address - Phone:410-749-4154
Practice Address - Fax:410-860-9583
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD47674207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000647801Medicaid
0003W409OtherBCBS PROD FEP BLUE CHOICE
200022317OtherRAILROAD MEDICARE
VA091051OtherTRIGON BCBS
MD358971400Medicaid
221921800OtherUS DEPARTMENT OF LABOR
MD229296OtherMDIPA OPTIMUM CHOICE
VA006403247Medicaid
1002198OtherAETNA
910711OtherFREESTATE DELMARVA HEALTH
327279OtherPRIME HEALTH
53484401H524PEOtherBCBS TRAD PRODUCTS
66G44OtherEMPIRE BCBS
0003W409OtherBCBS PROD FEP BLUE CHOICE
221921800OtherUS DEPARTMENT OF LABOR