Provider Demographics
NPI:1427048198
Name:MCAULIFFE, GREGORY F (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:F
Last Name:MCAULIFFE
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Mailing Address - Street 1:106 BLANCA AVE
Mailing Address - Street 2:SLV REGIONAL MEDICAL CENTER
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101-2340
Mailing Address - Country:US
Mailing Address - Phone:719-589-8005
Mailing Address - Fax:719-589-8023
Practice Address - Street 1:106 BLANCA AVE
Practice Address - Street 2:SLV REGIONAL MEDICAL CENTER
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2340
Practice Address - Country:US
Practice Address - Phone:719-589-8005
Practice Address - Fax:719-589-8023
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2015-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN44010207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP33679OtherHEALTH PARTNERS
08022001OtherMMSI
241141OtherARAZ GROUP AMERICAS PPO
767663800OtherMEDICAL ASSISTANCE MA
0403073OtherMEDICA HEALTH PLANS
1028017OtherPREFERRED ONE
MN767663800Medicaid
50F29MCOtherBLUE CROSS BLUE SHIELD
110225228OtherRR MEDICARE
140947OtherUCARE
2114114OtherFIRST HEALTH PLAN
110007702Medicare ID - Type Unspecified
MN767663800Medicaid
110225228OtherRR MEDICARE
110010654Medicare PIN