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Individual
DAMON E GREVEN
Active
Individual
DAMON E GREVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002515A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000566036
ANTHEM
IN
05
—
0748972
—
OH
05
—
100081380
—
IN
05
—
200879230
—
IN
05
—
2788354
—
OH
01
—
P00664349
MEDICARE RAILROAD
IN
Enumeration date
10/15/2007
Last updated
01/05/2022
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