Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 31823 | SC |
N | 207RG0300X | Geriatric Medicine | D024942 | MD |
NPI | 1093881294 |
---|---|
Provider Name | Dr. Gregory Alan Compton |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-6221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2006 |
Last Update Date | 14/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
77243-1400 | (05) | MD |
B94578 | (02) | MD |
P00851423 | RR MEDICARE PTAN (01) | SC |