| NPI | 1093901480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYLE DAWN SOUTHERN Physician 317-923-1274 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 01033547A) |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2015-12-07 |