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1679502165

NPI Code Detail

MEDICARE: DR. GREGORY ALAN MERRELL M.D.

MEDICARE: DR. GREGORY ALAN MERRELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	01063616A	IN
2	207XS0106X	Orthopaedic Hand Surgery Physician	01063616A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00964083	OTHER	IN	RR MEDICARE PIN FOR IU
6	P00657824	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7770886	OTHER	IN	AETNA
2	000000527570	OTHER	IN	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	000000708751	OTHER	IN	ANTHEM PROVIDER NUMBER UNDER TIN 35-2030653

General Provider Information

NPI Number	:	1679502165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY ALAN MERRELL M.D.

Provider Business Mailing Address
First Line	:	8501 HARCOURT RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2046
Country	:	US
Telephone Number	:	317-875-9105
Fax Number	:	317-875-8638

Provider Business Practice Location Address
First Line	:	8501 HARCOURT RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2046
Country	:	US
Telephone Number	:	317-875-9105
Fax Number	:	317-808-8802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	04/01/2024

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Directions to “ DR. GREGORY ALAN MERRELL M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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