Organization
GARY GETTELFINGER MD DABPM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GETTELFINGER (PRESIDENT AND CEO)
(219) 476-0352
Entity
Organization
Contact information
Practice address
1619 N PRAIRIE GREEN CT, BLOOMINGTON, IN 47408-8701
(812) 353-2700
Mailing address
1619 N PRAIRIE GREEN CT, BLOOMINGTON, IN 47408-8701
(812) 353-2700
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
01036884
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200039570
—
IN
01
—
547540K
MEDICARE PTAN
IN
Enumeration date
12/27/2016
Last updated
12/27/2016
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