Individual
ADAM M GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3707 NEW VISION DR, FORT WAYNE, IN 46845-1702
(260) 469-6602
(260) 484-5919
Mailing address
3707 NEW VISION DR, FORT WAYNE, IN 46845-1702
(260) 469-6602
(260) 484-5919
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01058285A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200870830
—
IN
01
—
P00452683
RAILROAD MEDICARE
IN
Enumeration date
05/31/2007
Last updated
03/05/2021
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