Provider Demographics
NPI:1811034705
Name:FEY, GREGORY CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:CHARLES
Last Name:FEY
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 1:104A ANNAPOLIS ST
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1310
Mailing Address - Country:US
Mailing Address - Phone:410-793-7050
Mailing Address - Fax:888-295-2403
Practice Address - Street 1:104A ANNAPOLIS ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1310
Practice Address - Country:US
Practice Address - Phone:410-793-7050
Practice Address - Fax:888-295-2403
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00588072084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
262345590OtherEIN/TIN