Basic Information
Provider Information
NPI: 1508033408
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRAMLING
FirstName: ANNA
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 SOUTHFIELD DR
Address2: SUITE 1370
City: PLAINFIELD
State: IN
PostalCode: 461684498
CountryCode: US
TelephoneNumber: 3178375571
FaxNumber: 3178375580
Practice Location
Address1: 1100 SOUTHFIELD DR
Address2: SUITE 1330
City: PLAINFIELD
State: IN
PostalCode: 461684498
CountryCode: US
TelephoneNumber: 3178375510
FaxNumber: 3178375520
Other Information
ProviderEnumerationDate: 05/11/2008
LastUpdateDate: 03/05/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/05/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RR0500X01072820AINY Allopathic & Osteopathic PhysiciansInternal MedicineRheumatology

No ID Information.


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