Individual
DR. GREGORY LOWELL WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1701 N SENATE BLVD STE 4110, INDIANAPOLIS, IN 46202-1239
(317) 577-4200
(317) 577-9503
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02004381A
IN
207L00000X
Anesthesiology Physician
4768
AZ
207L00000X
Anesthesiology Physician
M2497
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095200145
MEDICARE PTAN
IN
01
—
264430G51
MEDICARE PTAN
IN
05
—
300070132
—
IN
Enumeration date
01/16/2006
Last updated
09/08/2023
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