Provider Demographics
NPI:1740674944
Name:GREVIOUS, SALIH NIGEL (MD)
Entity type:Individual
Prefix:DR
First Name:SALIH
Middle Name:NIGEL
Last Name:GREVIOUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SALIH
Other - Middle Name:NIGEL
Other - Last Name:GREVIOUS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2605 KEISER BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3338
Mailing Address - Country:US
Mailing Address - Phone:610-685-8500
Mailing Address - Fax:610-685-4833
Practice Address - Street 1:2605 KEISER BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3338
Practice Address - Country:US
Practice Address - Phone:610-685-8500
Practice Address - Fax:610-685-4833
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA278845207RC0000X, 207RC0000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program