Provider Demographics
NPI:1013606011
Name:GREER, DONALD ERNEST JR
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ERNEST
Last Name:GREER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 S 775 W
Mailing Address - Street 2:
Mailing Address - City:SAN PIERRE
Mailing Address - State:IN
Mailing Address - Zip Code:46374-9649
Mailing Address - Country:US
Mailing Address - Phone:574-207-3072
Mailing Address - Fax:
Practice Address - Street 1:3500 FRANCISCAN WAY
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-0021
Practice Address - Country:US
Practice Address - Phone:219-879-8511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28200905A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily