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Individual

RICHARD J GNAEDINGER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1007 LINCOLNWAY, LA PORTE, IN 46350-3201
(219) 326-1234
Mailing address
800 LINCOLNWAY, SUITE 301, LA PORTE, IN 46350-3438
(219) 324-2229
(219) 324-2229

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01049409A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000185348
ANTHEM ID
IN
01
050066349
RAILROAD
IN
05
200194830
IN
Enumeration date
11/13/2006
Last updated
06/07/2024
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