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Individual
G GREGG NEIBAUER
Active
Individual
G GREGG NEIBAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
160
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000084041
MEDICARE GROUP PIN
MT
05
—
0390779
—
MT
01
—
97315
BLUE CROSS BLUE SHIELD
MT
01
—
P00097318
RAILROAD MEDICARE
MT
Enumeration date
11/01/2007
Last updated
04/07/2014
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