Individual
GREGORY S. KNUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
551 W CENTRAL AVE STE 102, DELAWARE, OH 43015-1498
(740) 368-5550
(740) 368-5591
Mailing address
PO BOX 7527, DUBLIN, OH 43017-0727
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
35.063160
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000014762
ANTHEM BCBS
OH
01
—
0004221655
AETNA
OH
05
—
0871187
—
OH
01
—
1900116
UNITED HEALTHCARE-M&D
—
01
—
1900506
UNITED HEALTHCARE-S
—
01
—
340006194
RR MEDICARE
—
Enumeration date
11/22/2006
Last updated
09/22/2022
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