| NPI | 1376679753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D PROVINCE President 317-736-7177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IN 50001108A) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |