Individual
JEREMY RYAN GROGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 311, FORT WAYNE, IN 46845-1714
(260) 266-8840
(260) 266-8849
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
01066660A
IN
Other
Enumeration date
05/31/2008
Last updated
03/06/2023
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