Provider Demographics
NPI:1740363704
Name:PRICE, GREGORY M (MD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:M
Last Name:PRICE
Suffix:
Gender:M
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:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-4810
Mailing Address - Fax:
Practice Address - Street 1:301 S COLLEGE ST
Practice Address - Street 2:SUITE 250
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-6000
Practice Address - Country:US
Practice Address - Phone:704-316-4810
Practice Address - Fax:704-316-4815
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200500642207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC140NTOtherBLUE CROSS BLUE SHIELD
NC0106137OtherUNITED HEALTHCARE
NC5901764Medicaid
NC9195378OtherCIGNA
NC2045698GMedicare PIN
NC140NTOtherBLUE CROSS BLUE SHIELD
NC2045698CMedicare PIN
NC5901764Medicaid
NC2045698FMedicare PIN
NC2045698DMedicare PIN
NC9195378OtherCIGNA
NC2045698EMedicare PIN
NC2045698Medicare PIN