Organization
MAIN STREET CLINIC
Active
Other names
Wells Medical Services
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J. GREENMAN M.D. (M.D/CEO-PRESIDENT)
(260) 824-9265
Entity
Organization
Contact information
Practice address
117 S MAIN ST, BLUFFTON, IN 46714-2047
(260) 824-9265
(260) 824-9267
Mailing address
117 S MAIN ST, BLUFFTON, IN 46714-2047
(260) 824-9265
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01034958
IN
2080A0000X
Pediatric Adolescent Medicine Physician
01034958
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100101710A
—
IN
Enumeration date
03/07/2018
Last updated
03/07/2018
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