Individual
DR. SHAUN J GRANNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1520 N SENATE AVE, INDIANAPOLIS, IN 46202-2213
(317) 962-8188
(317) 423-5695
Mailing address
410 W 10TH ST, SUITE 2000, INDIANAPOLIS, IN 46202-3002
(317) 423-5523
(317) 423-5695
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01055270A
IN
Other
Enumeration date
06/30/2005
Last updated
07/08/2007
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