Individual
JOHN C GROTBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 962-5820
(317) 962-3916
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
(314) 996-5000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01093052A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01093052A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2022034948
MO
207RP1001X
Pulmonary Disease Physician
Primary
01093052A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300089550
—
IN
Enumeration date
06/19/2018
Last updated
03/12/2025
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