Provider Demographics
NPI:1427047737
Name:GREGORY, ANDREW R (OD, MHA, MBA)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:R
Last Name:GREGORY
Suffix:
Gender:M
Credentials:OD, MHA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15251 SIESTA KEY WAY APT 263
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5505
Mailing Address - Country:US
Mailing Address - Phone:210-601-3435
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-5641
Practice Address - Country:US
Practice Address - Phone:301-295-0213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1980152W00000X
TX6807T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist