NPI | 1649749052 |
---|---|
Doing Business As | GATEWAY IMMEDIATE CARE |
Entity Type | Organization |
Authorized Contact | STEVEN LONG CEO 317-468-4412 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
363L00000X Nurse Practitioner | |
Enumeration Date | 2018-11-14 |
Last Update Date | 2019-06-25 |