Provider Demographics
NPI:1184310690
Name:NORWOOD, GREGORY
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 CRESCENT ST STE 202
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02453-3425
Mailing Address - Country:US
Mailing Address - Phone:781-487-1107
Mailing Address - Fax:
Practice Address - Street 1:206 GATEWOOD AVE
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4820
Practice Address - Country:US
Practice Address - Phone:336-281-6400
Practice Address - Fax:833-918-2111
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-7295-01175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist