Individual
GREGORY BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7519 HOSPITAL DR, GLOUCESTER, VA 23061-4178
(804) 693-8800
Mailing address
5721 KINGS RIDGE RD, GLOUCESTER, VA 23061-4336
(804) 695-0941
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101-221456
VA
207P00000X
Emergency Medicine Physician
044164
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265457618
—
VA
Enumeration date
07/13/2006
Last updated
05/30/2008
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