Individual
BRIEN N GROW
Active
Individual
BRIEN N GROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02001260A
IN
207P00000X
Emergency Medicine Physician
02001260A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000728092
ANTHEM
IN
05
—
100366310
—
IN
05
—
100366310B
—
IN
05
—
200395990A
—
IN
Enumeration date
07/19/2006
Last updated
05/20/2016
Update your record
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