Provider Demographics
NPI:1215906151
Name:VALAINIS, GREGORY THOMAS (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:THOMAS
Last Name:VALAINIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:1330 BOILING SPRINGS RD
Practice Address - Street 2:SUITE 2500
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-2244
Practice Address - Country:US
Practice Address - Phone:864-585-5433
Practice Address - Fax:864-591-4053
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14717207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC440002537OtherRR MEDICARE
NC890591XMedicaid
SCB617055019OtherMEDICARE PIN
SCP01510928OtherRAILROAD MEDICARE
SCP00313297OtherRR MEDICARE
SCP00691786OtherRR MEDICARE
SCB617053365OtherMEDICARE PIN
SC147175Medicaid
SCSC53956084OtherMEDICARE PIN
SCP00691786OtherRR MEDICARE
SCB617053365OtherMEDICARE PIN
SCB617055019OtherMEDICARE PIN