Individual
DR. MARY COFFEY GREIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6820 PARKDALE PLACE, SUITE 211, INDIANAPOLIS, IN 46254-6600
(317) 329-7050
(317) 328-6809
Mailing address
6820 PARKDALE PLACE, SUITE 211, INDIANAPOLIS, IN 46254-6600
(317) 329-7050
(317) 328-6809
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
01024873
IN
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
01024873
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085208
ANTHEM
IN
05
—
100060500
—
IN
Enumeration date
10/06/2006
Last updated
05/26/2010
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