Provider Demographics
NPI:1861466559
Name:GREGOR, SARAH MARGARET (MS)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:MARGARET
Last Name:GREGOR
Suffix:
Gender:F
Credentials:MS
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 936
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23501-0936
Mailing Address - Country:US
Mailing Address - Phone:757-446-0374
Mailing Address - Fax:757-624-2272
Practice Address - Street 1:825 FAIRFAX AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1914
Practice Address - Country:US
Practice Address - Phone:757-446-7438
Practice Address - Fax:757-624-2272
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001218207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VANONOtherUSA MANAGE D CARE
VANONOtherCORVEL CORCARE
VA2122625OtherUHC/MAMSI/MDIPA
NCNONOtherBC/BS NC
VANONOtherVA PREMIER
VANONOtherMID-ATLANTIC/VICARE
VAPAROtherVHN/P HCS
VANONOtherCIGNA
VANONOtherAETNA PPO
NCNONOtherMULTI PLAN
VANONOtherFIRST HEALTH
VA139025OtherANTHEM BC/BS
NCNONMedicaid
VA010073391Medicaid
VANONOtherAMERICAS HEALTH PLAN
VAPAROtherSENTARA OHP/SHP
VAQ10147Medicare UPIN
VA139025OtherANTHEM BC/BS
VA003944E75Medicare ID - Type UnspecifiedVA RR MCR