Individual
ANTHONY DANIEL GRECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5658 WHITE MOUNTAIN BLVD, SUITE 7, LAKESIDE, AZ 85929-5189
(928) 532-5463
(928) 532-8474
Mailing address
PO BOX 2260, LAKESIDE, AZ 85929-2260
(928) 242-2422
(928) 532-8474
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22688
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179318
—
AZ
01
—
AZ0789570
BLUE CROSS BLUE SHIELD AZ
AZ
Enumeration date
01/30/2006
Last updated
03/14/2016
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