Provider Demographics
NPI:1396768610
Name:MCGREW, PHILIP BENJAMIN
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:BENJAMIN
Last Name:MCGREW
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 1:2238 S CHIPLEY FORD RD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28625-8706
Mailing Address - Country:US
Mailing Address - Phone:704-878-2923
Mailing Address - Fax:
Practice Address - Street 1:2238 S CHIPLEY FORD RD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28625-8706
Practice Address - Country:US
Practice Address - Phone:704-873-3777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1799111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0806COtherBLUE CROSS BLUE SHIELD OF
NC21962OtherPARTNERS MEDICARE
NC890860CMedicaid
NC330716OtherAMERICAN CHIROPRACTIC NET
NC738494OtherMAMSI
NC738494OtherMAMSI
NC21962OtherPARTNERS MEDICARE