Provider Demographics
NPI:1811006646
Name:GREISS-COULT, MARY PEARL (DO)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:PEARL
Last Name:GREISS-COULT
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1611 POND RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2258
Mailing Address - Country:US
Mailing Address - Phone:610-366-7444
Mailing Address - Fax:610-366-0884
Practice Address - Street 1:1611 POND RD
Practice Address - Street 2:SUITE 102
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2258
Practice Address - Country:US
Practice Address - Phone:610-366-7444
Practice Address - Fax:888-546-4216
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-09-12
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Provider Licenses
StateLicense IDTaxonomies
PAOS012199207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2828475000OtherINDEPENDENCE BLUE CROSS
PA2634499OtherSOLO- HIGHMARK BLUE SHIELD
PA3840818000OtherSOLO- INDEPENDENCE BLUE CROSS
PA7763855OtherAETNA
PA1951168OtherHIGHMARK BLUE SHIELD
PA1902192917OtherSOLO- HEALTH ASSURANCE/ HEALTH AMERICA/ COVENTRY
PA30101360OtherAMERIHEALTH MERCY
PA1018461090001Medicaid
PA26895627OtherSOLO- UNITED HEALTHCARE
PA30101359OtherSOLO- AMERIHEALTH MERCY
PA1026436200001OtherSOLO- MEDICAID
PA4152777OtherSOLO- CIGNA
PA50101951OtherCAPITAL BLUE CROSS
PA1811006646OtherHEALTH ASSURANCE/ HEALTH AMERICA/ COVENTRY
PA50101952OtherSOLO- CAPITAL BLUE CROSS
PA9634726OtherSOLO- AETNA
PA224848OtherSOLO- MEDICARE
PA112471Medicare PIN