Individual
ANDREW J GRESKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2376 CYPRESS CIR, SUITE 102, CONWAY, SC 29526-8964
(843) 347-8953
(843) 347-0226
Mailing address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(843) 234-6948
(843) 234-6990
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
16174
SC
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
16174
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161746
—
SC
01
—
P01204804
RAILROAD MEDICARE
SC
Enumeration date
08/10/2005
Last updated
02/21/2019
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