Provider Demographics
NPI:1538235452
Name:GILBY, GREG (DC)
Entity type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:GILBY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10121 AVALON DR
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02188-4629
Mailing Address - Country:US
Mailing Address - Phone:781-337-6054
Mailing Address - Fax:
Practice Address - Street 1:653 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02125-1712
Practice Address - Country:US
Practice Address - Phone:617-825-9100
Practice Address - Fax:617-825-5006
Is Sole Proprietor?:No
Enumeration Date:2006-11-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2761111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0038842OtherNEIGHBORHOOD HEALTH PLAN
MA701240OtherACN GRP-UNITEDHEALTHCARE
MAY37017OtherBLUE CROSS BLUE SHIELD
MAAA14524OtherHARVARD PILIGRIM HC
MA1600451Medicaid
MAY45629Medicare ID - Type Unspecified