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Individual

DR. DONALD J GREGGAIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
415 6TH ST STE 3C, LEWISTON, ID 83501-2431
(208) 750-3840
(208) 750-3839
Mailing address
415 6TH STREET, ATTN: PHYSICIAN SERVICES, LEWISTON, ID 83501-2434
(208) 750-7462
(208) 750-7467

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
32331
WA
207Q00000X
Family Medicine Physician
Primary
M-6680
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010001249
REGENCE BLUE SHIELD PROV
ID
05
003310000
ID
01
080075556
RAILROAD MEDICARE PROV#
05
1003592
WA
01
104012
DL&I PROV NUMBER
WA
01
1095264
WASH MEDICAID PROV #
WA
01
1139282
IDAHO MEDICARE PROV #
ID
05
1154328052
ID
01
193254001
OWCP PROV #
01
71993 8J935
BLUE CROSS IDAHO PROV#
ID
Enumeration date
07/07/2005
Last updated
12/26/2024
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