Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 27130 | SC |
N | 207V00000X | Obstetrician & Gynecologist | 27130 | SC |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 27130 | SC |
NPI | 1205890399 |
---|---|
Provider Name | Dr. Anthony Romaine Gregg |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203-6808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 07/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003587300 | (05) | FL |
271306 | (05) | SC |
E67800 | (02) |