Masimore, Gregory Scott
Masimore, Gregory Scott is an sole proprietor health care provider with primary practice located at 730 Executive Park Dr Ste A , Greenwood IN 46143-3213. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Masimore, Gregory Scott can be contacted via phone (317) 346-7246.Contact Information
Primary practice address
730 Executive Park Dr Ste A
Greenwood IN 46143-3213
Phone: (317) 346-7246
Fax: (317) 543-3763
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 01042621A | Indiana |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 01042621A | Indiana |
Profile Details
| NPI number | 1104878982 |
|---|---|
| LBN Legal business name | Masimore, Gregory Scott |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 17th, 2006 |
| Last updated | Dec 13th, 2017 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104878982 | NPPES |
| Indiana | Other | 000000476069 | SIA ANTHEM |
| Indiana | MEDICAID | 200816430 | SIA ANTHEM |
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