Provider Demographics
NPI:1952416414
Name:MCGREGOR, MARK M (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:M
Last Name:MCGREGOR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-3493
Mailing Address - Country:US
Mailing Address - Phone:508-771-1115
Mailing Address - Fax:508-771-0655
Practice Address - Street 1:677 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-3493
Practice Address - Country:US
Practice Address - Phone:508-771-1115
Practice Address - Fax:508-771-0655
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1273111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA1014OtherHARVARD PILGRIM
MA476767OtherAETNA
MA727382OtherTUFTS
MAY35910OtherBC/BS INDIVIDUAL
MAY39042OtherBC/BS GROUP
MA727382OtherTUFTS
MAAA1014OtherHARVARD PILGRIM