Individual
GREGORY MAYRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, 5 MALONEY, PHILADELPHIA, PA 19104-4206
(215) 662-4000
(215) 254-3289
Mailing address
3400 SPRUCE ST, 5 MALONEY, PHILADELPHIA, PA 19104-4206
(215) 662-4000
(215) 254-3289
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD423087
PA
207RI0200X
Infectious Disease Physician
MD423087
PA
208M00000X
Hospitalist Physician
Primary
MD423087
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102020604 0001
—
PA
Enumeration date
09/13/2007
Last updated
05/01/2019
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