Gresla, Mark S

Gresla, Mark S is an sole proprietor health care provider with primary practice located at 955 High St Suite 3, Decatur IN 46733-2326. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gresla, Mark S can be contacted via phone (260) 724-2125.

Contact Information

Primary practice address
955 High St Suite 3 Decatur IN 46733-2326
Phone: (260) 724-2125
Fax: (260) 724-3859
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01034460A Indiana

Profile Details

NPI number 1467482034
LBN Legal business name Gresla, Mark S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 3rd, 2006
Last updated Apr 19th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467482034 NPPES
Indiana Other 9131 NO. IN PHP
Indiana MEDICAID 100146990A NO. IN PHP
Indiana Other 000000087488 NO. IN PHP

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