Individual
ELIZABETH A GRONINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
900 EDWARDS DR, PLAINFIELD, IN 46168-5680
(317) 839-2368
(317) 839-1267
Mailing address
900 EDWARDS DR, PLAINFIELD, IN 46168-5680
(317) 839-2368
(317) 839-2338
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002476
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083757
ANTHEM
IN
01
—
11478976
CAQH
IN
Enumeration date
07/27/2006
Last updated
07/22/2019
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