Provider Demographics
NPI:1447252978
Name:GREBING, BRETT R (MD)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:R
Last Name:GREBING
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6812 STATE ROUTE 162
Mailing Address - Street 2:SUITE 123
Mailing Address - City:MARYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62062
Mailing Address - Country:US
Mailing Address - Phone:618-288-9460
Mailing Address - Fax:618-288-9461
Practice Address - Street 1:6812 STATE ROUTE 162
Practice Address - Street 2:SUITE 123
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062
Practice Address - Country:US
Practice Address - Phone:618-288-9460
Practice Address - Fax:618-288-9461
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2013-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO113320207X00000X, 207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
H72045Medicare UPIN