MARY LEE GREGORY M.D./PH.D. NPI 1376710970

NPI Information

NPI: 1376710970
Provider Name: MARY LEE GREGORY, M.D./PH.D.
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Individual

Specialization: Neurology with Special Qualifications in Child Neurology

PECOS Registration: Yes

Address:
9 RICHLAND MEDICAL PARK DR STE 110
COLUMBIA, SC
ZIP 29203
Phone: (803) 434-7961
Get Directions

Mary Lee Gregory, M.D./PH.D. is a neurology with special qualifications in child neurology psychiatry neurology in Columbia, SC. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. Mary Lee Gregory, M.D./PH.D. NPI is 1376710970. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

9 RICHLAND MEDICAL PARK DR STE 110
COLUMBIA, SC
ZIP 29203-859
Phone: (803) 434-7961
Fax: (803) 758-0134

The NPI 1376710970 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/13/2008 and was last updated on 4/28/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	81904	SOUTH CAROLINA	Yes
2	2084N0402X	Psychiatry & Neurology	Neurology with Special Qualifications in Child Neurology	074718	GEORGIA	No
3	390200000X	Student in an Organized Health Care Education/Training Program				No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	GA1803	MEDICAID	SOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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