Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 01032174A | IN |
Y | 111NI0900X | Internist | 01032174A | IN |
N | 207RH0002X | Hospice and Palliative Medicine | 01032174A | IN |
NPI | 1013974088 |
---|---|
Provider Name | Gregory P Gramelspacher |
First Address | Indianapolis, IN 46268-6100 |
Second Address | Indianapolis, IN 46202-2859 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 16/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000086757 | ANTHEM (01) | IN |
100129550 | (05) | IN |
A97779 | (02) | IN |