Individual
GREGORY W FARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 630-7276
(317) 656-4216
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01073676A
IN
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
01073676A
IN
208000000X
Pediatrics Physician
01073676A
IN
208000000X
Pediatrics Physician
35.097527
OH
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
01073676A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000864526
ANTHEM PTAN
IN
05
—
201060680
—
IN
Enumeration date
08/25/2008
Last updated
03/07/2025
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