Edmund A Griley, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Tamuning, GU
NPI 1114079589 · NPPES record last updated Nov 24, 2014
Key facts
- NPI
- 1114079589
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- M00714 (GU)
- Practice address
- #138 Ypao Road
Tamuning, GU 96931 - Phone
- (671) 646-6111
- Fax
- (671) 646-6115
- NPI assigned
- Jan 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M00714 | GU | MD | Obstetrics & Gynecology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | M00714 | GU | Yes |
Addresses
Primary practice location
#138 Ypao Road
Tamuning, GU 96931
Mailing address
PO Box 315574
Tamuning, GU 96931-3474
Phone (671) 646-6111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 027 | Medicaid | GU |
Other names
- Edmund A Griley Guevara
Other providers in Tamuning, GU
- Andrew David Graves
- Eric Mark Greenfield
- Brian Wayne Greening
- Barbara J Gregory
- Robert W Gregory
- Guahan Physicians and Consultants
- Guahan Specialty and Wellness Center, LLC
- Guam Anesthesia and Pain Service
- Guam Anesthesia Services
- Guam Dermatology Institute LLC
All providers in Tamuning, GU · Obstetrics & Gynecology Physician in Guam
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.