Individual
DR. GREGORY R WAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12188A N MERIDIAN ST, SUITE # 200, CARMEL, IN 46032-4578
(317) 564-5100
(317) 564-5556
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 807-1262
(317) 859-4268
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01040415A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000198907
ANTHEM PIN NUMBER
IN
01
—
100194370
MEDICAID GROUP NUMBER
IN
05
—
100319050
—
IN
01
—
1487680518
GROUP NPI
IN
01
—
200288740
MEDICAID GROUP NUMBER
IN
01
—
340019239
MEDICARE RAILROAD
IN
Enumeration date
07/31/2006
Last updated
03/17/2021
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