Provider Demographics
NPI:1699844225
Name:SAWIN, GREGORY E (MD, MPH)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:E
Last Name:SAWIN
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:GREGORY
Other - Middle Name:E
Other - Last Name:LARSON SAWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:2200 W MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-1108
Mailing Address - Country:US
Mailing Address - Phone:919-684-5614
Mailing Address - Fax:
Practice Address - Street 1:3116 N DUKE ST FL 1
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2102
Practice Address - Country:US
Practice Address - Phone:919-660-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA232606207Q00000X
VA0101238112207Q00000X
NC2019-02755207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2140284Medicaid
MA2140284Medicaid
007854U92Medicare PIN