Provider Demographics
NPI:1265401533
Name:MAY, GREGORY KENNETH (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:KENNETH
Last Name:MAY
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 1:1211 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1099
Mailing Address - Country:US
Mailing Address - Phone:360-532-3808
Mailing Address - Fax:360-533-4884
Practice Address - Street 1:1211 SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-1099
Practice Address - Country:US
Practice Address - Phone:360-532-3808
Practice Address - Fax:360-533-4884
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032541207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8177057Medicaid
F45331Medicare UPIN
WA8177057Medicaid