Individual
GRANT E MCDOUGAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9011 N MERIDIAN ST STE 225, INDIANAPOLIS, IN 46260-5365
(317) 574-4747
Mailing address
9011 N MERIDIAN ST STE 225, INDIANAPOLIS, IN 46260-5365
(317) 574-4747
(317) 574-4737
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01051076A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200444340
—
IN
Enumeration date
09/13/2005
Last updated
12/26/2025
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