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Contact Information

GREGORY S MASIMORE, MD
730 EXECUTIVE PARK DR STE A
GREENWOOD, IN46143
 Phone: 317-346-7246
 Fax: 317-534-3763
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pain Medicine

208VP0000X 72 Physician/Pain Management
 

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
Indicates primary specialty

NPI Profile & details for GREGORY S MASIMORE · (Male)

NPI # 1104878982
Status Active
Credentials MD
Entity Individual
Enumeration date 05/17/2006
Last updated 12/13/2017 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • IN License # 01042621A
  • IN Medicaid 200816430
  • IN Other 000000476069 SIA ANTHEM
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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