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Individual
GREGORY THOMAS SQUIRES
Active
Individual
GREGORY THOMAS SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
21090
SC
208600000X
Surgery Physician
021090
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10988297
CIGNA
SC
05
—
GP4370
—
SC
Enumeration date
04/17/2006
Last updated
10/08/2024
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