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DR. MARK ALLEN GREVIOUS M.D. NPI 1194727909


NPI Information

NPI: 1194727909
Provider Name: DR. MARK ALLEN GREVIOUS, M.D.
Classification: Plastic Surgery - 208200000X
Entity Type: Individual

PECOS Registration: Yes

Address:
7905 CALUMET AVE
MUNSTER, IN
ZIP 46321
Phone: (219) 836-7506
Get Directions

DR. Mark Allen Grevious, M.D. is a plastic surgery in Munster, IN with 30 years of experience. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. DR. Mark Allen Grevious, M.D. NPI is 1194727909. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: RUTGERS NEW JERSEY MEDICAL SCHOOL
Graduation Year:1994

The provider's business location address is:

7905 CALUMET AVE
MUNSTER, IN
ZIP 46321-549
Phone: (219) 836-7506
Fax: (219) 836-7515

The NPI 1194727909 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/11/2005 and was last updated on 9/14/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208200000XPlastic Surgery01060561AINDIANANo
2208200000XPlastic Surgery036100551ILLINOISNo
3208600000XSurgery01060561AINDIANANo
42086S0122XSurgeryPlastic and Reconstructive Surgery036100551ILLINOISNo
5208200000XPlastic Surgery72578MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036-100551-1MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.