| Doctor Name: | GREGORY S MENCKEN |
| NPI Number: | 1922084961 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 17301 |
| Business Practice Address: | 300 Singleton Ridge Rd Conway, SC - 295269142 |
| Business Phone Number: | 8432388660 |
| Business Fax Number: | |
| Mailing Address: | Po Box 51030, MYRTLE BEACH |
| State: | SC |
| Postal Code: | 295790018 |
| Phone Number: | 8432388660 |
| Fax Number: | |
| NPI Enumeration Date: | 12/21/2005 |
| NPI Last Update Date: | 11/22/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | 17301 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |