Individual
HARRY GLYN GREDITZER JR.
Active
Individual
HARRY GLYN GREDITZER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
R7801
MO
2085R0202X
Diagnostic Radiology Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006021895
IL BLUE
—
01
—
100265
H LINK
—
01
—
1077061
MC MCAID
—
01
—
1390
MO BLUE
—
01
—
1611000
PH PLAN
—
01
—
22730
BLUE CHOICE
—
01
—
2781
GHP
—
01
—
317617
HLT PART
—
01
—
6006
HCARE USA
—
01
—
A27719
GATE WAY
—
01
—
L40182
IL CARE
—
Enumeration date
07/28/2006
Last updated
07/08/2007
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