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General NPI Number Information
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NPI Number | 1265700090
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Entity Type | Individual
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Provider Name | GREGORY GEORGE BINGAMAN NP
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Gender | Male
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Dates
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Enumeration Date | 12/07/2011
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 621 MEMORIAL DR STE 502
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City | SOUTH BEND
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State | IN
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Zip | 46601-1075
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Country | US
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Telephone | 574-647-5875
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Fax | 574-647-5878
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Provider Business Mailing Address
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Address Line | 3245 HEALTH DR STE 100
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City | GRANGER
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State | IN
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Zip | 46530-1380
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Country | US
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Telephone | 574-647-3437
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704338962
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 71003819A
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License Number State | IN
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