Mauldin, Gregory Loy

Mauldin, Gregory Loy is an individual health care provider with primary practice located at 1800 Tree Lane Road Suite 200, Snellville GA 30078. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Critical Care Medicine is his primary health care specialty. Mauldin, Gregory Loy can be contacted via phone (770) 979-0367.

Contact Information

Primary practice address
1800 Tree Lane Road Suite 200 Snellville GA 30078
Phone: (770) 979-0367
Fax: (770) 979-1830
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 036567 Georgia
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 36567 Georgia

Profile Details

NPI number 1871673749
LBN Legal business name Mauldin, Gregory Loy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 16th, 2006
Last updated Jul 19th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871673749 NPPES
Georgia Other GRP2664 GROUP MEDICARE #
Georgia Other CD7170 GROUP MEDICARE #
Georgia MEDICAID 00540119A GROUP MEDICARE #

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