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Individual

DR. GREGORY A GAGNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
600 MOYE BLVD, ECU PHYSICIANS PATHOLOGY, GREENVILLE, NC 27834-4300
(252) 744-2207
(252) 744-3616
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
37830
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
220020379
RAILROAD MEDICARE
NC
01
34316
BCBS NC
NC
05
8934316
NC
Enumeration date
08/11/2005
Last updated
06/25/2013
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