Provider Demographics
NPI:1831383678
Name:GRECCO, JULIAN (MD)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:GRECCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JULIAN
Other - Middle Name:
Other - Last Name:GNECCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 35100
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-5100
Mailing Address - Country:US
Mailing Address - Phone:406-238-2500
Mailing Address - Fax:
Practice Address - Street 1:2800 10TH AVE N
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101
Practice Address - Country:US
Practice Address - Phone:406-238-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11484207R00000X
MTMED-PHYS-LIC-11484208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000098436OtherBCBS PIN
MTP00425597Medicare PIN
WYW21653Medicare PIN
MT000098436OtherBCBS PIN
MT011000851Medicare PIN
MT011000852Medicare PIN