Individual
GREGORY L TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1111 LIGHTHOUSE LN, GOSHEN, IN 46526-3824
(574) 533-0348
(574) 533-0277
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01069009A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201006270
—
IN
Enumeration date
07/24/2006
Last updated
08/25/2023
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