Individual
GREGG DAVID SCHUBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2101 W ARLINGTON BLVD STE 210, GREENVILLE, NC 27834-5758
(252) 931-7638
(252) 931-7694
Mailing address
PO BOX 30750, GREENVILLE, NC 27833-0750
(252) 931-7638
(252) 931-7694
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
MD059410L
PA
2085R0202X
Diagnostic Radiology Physician
Primary
2022-01961
NC
2085R0202X
Diagnostic Radiology Physician
MD059410L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012411910001
—
PA
01
—
188552-1
LICENSE
NY
01
—
25MA07565100
LICENSE
NJ
01
—
730893
HIGHMARK
—
01
—
MD059410L
LICENSE
PA
Enumeration date
07/11/2005
Last updated
03/07/2023
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