Individual
DR. GREGORY ALAN MERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 808-8802
Mailing address
8501 HARCOURT RD, INDIANAPOLIS, IN 46260-2046
(317) 875-9105
(317) 875-8638
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01063616A
IN
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
01063616A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000527570
ANTHEM
IN
01
—
000000708751
ANTHEM PROVIDER NUMBER UNDER TIN 35-2030653
IN
05
—
200868700
—
IN
01
—
7770886
AETNA
IN
01
—
P00657824
RR MEDICARE
IN
01
—
P00964083
RR MEDICARE PIN FOR IU
IN
Enumeration date
06/30/2006
Last updated
04/01/2024
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