Provider Demographics
NPI:1922093723
Name:GREGER, RONALD EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:EDWARD
Last Name:GREGER
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 1:201 RUSSELL AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-2800
Mailing Address - Country:US
Mailing Address - Phone:301-216-4157
Mailing Address - Fax:301-987-6297
Practice Address - Street 1:201 RUSSELL AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-2800
Practice Address - Country:US
Practice Address - Phone:301-216-4157
Practice Address - Fax:301-987-6297
Is Sole Proprietor?:No
Enumeration Date:2005-09-18
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014660207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD410467600Medicaid
MD211854OtherMEDICARE
MDG00680Medicare PIN
MD211854OtherMEDICARE