Provider Demographics
NPI:1679670251
Name:MCCUE, GREGORY P (MD)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:P
Last Name:MCCUE
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:PO BOX 35100
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-5100
Mailing Address - Country:US
Mailing Address - Phone:406-238-2500
Mailing Address - Fax:
Practice Address - Street 1:201 YELLOWSTONE AVE
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-9313
Practice Address - Country:US
Practice Address - Phone:307-527-7561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY3240A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0109701OtherMT MDCD PIN
WY925161030921OtherPREFERRED ONE PIN
WY104116900OtherWY MDCD PIN
MT000018381OtherMT BCBS PIN
WY307690OtherBCBS PIN
WY307690OtherBCBS PIN
WY104116900OtherWY MDCD PIN
WYD93619Medicare UPIN
WYW307963Medicare PIN