| NPI | 1306467048 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | STEVE MARTIN CEO 317-670-6635  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry | 
| 2084P0805X | |
| Enumeration Date | 2020-05-05 | 
| Last Update Date | 2020-05-05 |