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General NPI Number Information
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NPI Number | 1619403292
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Entity Type | Individual
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Provider Name | GREGORY DORILUS MD
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Gender | Male
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Dates
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Enumeration Date | 05/02/2017
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 2651 E DISCOVERY PKWY
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City | BLOOMINGTON
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State | IN
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Zip | 47408-9059
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Country | US
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Telephone | 812-353-9515
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Fax | 812-353-9275
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 01097203A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A171277
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 305257
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 35C.002960
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MA10743300
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License Number State | NJ
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