Provider Demographics
NPI:1013462399
Name:MCINTIRE, GREGORY (PHD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:MCINTIRE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:486 GALLIMORE DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-9725
Mailing Address - Country:US
Mailing Address - Phone:336-387-7621
Mailing Address - Fax:336-387-7600
Practice Address - Street 1:486 GALLIMORE DAIRY RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-9725
Practice Address - Country:US
Practice Address - Phone:336-387-7621
Practice Address - Fax:336-387-7600
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician