| NPI | 1770565830 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY RENAE STURGIS Supervisor 317-581-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01049047a) |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2015-08-18 |