Provider Demographics
NPI:1295706349
Name:GRECO, ROBERT M (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:GRECO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:48 TUNNEL RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:POTTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17901-3875
Mailing Address - Country:US
Mailing Address - Phone:570-622-0200
Mailing Address - Fax:570-622-8009
Practice Address - Street 1:48 TUNNEL RD
Practice Address - Street 2:SUITE 204
Practice Address - City:POTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17901-3875
Practice Address - Country:US
Practice Address - Phone:570-622-0200
Practice Address - Fax:570-622-4051
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2021-05-05
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Provider Licenses
StateLicense IDTaxonomies
PAMD036151E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001125485Medicaid
PAC31429Medicare UPIN
PA001125485Medicaid