| NPI | 1700393741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATALIE RAE BEMENT Executive Assistant 317-735-1851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine Adult Medicine (Licence: IN 01036126A) |
| Enumeration Date | 2017-12-29 |
| Last Update Date | 2017-12-29 |