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Individual

DR. GREGORY BUEL MCCOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1130 NW 22ND AVE, STE 535, PORTLAND, OR 97210-2900
(503) 297-4999
(503) 796-9884
Mailing address
847 NE 19TH AVE, SUITE 300, PORTLAND, OR 97232-2684
(503) 963-2801
(503) 963-2825

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD13218
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003395000
BLUE CROSS OR ALL
01
003395008
BLUE CROSS OR ALL
01
0079880
DEPT OF LABOR A
WA
05
1040765
WA
05
109371
OR
01
128281
DEPT OF LABOR A
WA
05
180133
OR
05
7858004
WA
01
930766376
ADVENTIST MEDICAL
01
A008
TRICARE
01
C91743
PROVIDENCE HEALTH
01
M677A
HEALTH NET
Enumeration date
10/04/2005
Last updated
10/06/2015
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