Provider Demographics
NPI:1740253731
Name:GREGG, CYNTHIA MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:MARIE
Last Name:GREGG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 NW CARY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-7409
Mailing Address - Country:US
Mailing Address - Phone:919-297-0097
Mailing Address - Fax:919-297-0082
Practice Address - Street 1:3550 NW CARY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-7409
Practice Address - Country:US
Practice Address - Phone:919-297-0097
Practice Address - Fax:919-297-0082
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCBG36908142086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8937024Medicaid
NC8937024Medicaid
NCF64856Medicare UPIN