Longevity Institute Of Indiana,p.C.
Dermatology in Indianapolis, IN. Organization (NPI-2).
NPI number1487842860
StatusActive
Last updated in NPPESJul 3, 2014
Details
- NPI
- 1487842860
- Entity type
- Organization (NPI-2)
- Legal business name
- Longevity Institute Of Indiana,p.C.
- Organization subpart
- No
- Enumeration date
- Oct 10, 2007
- Last updated
- Jul 3, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | 01021582A | IN | Yes |
Practice location
10291 N Meridian StSuite 300
Indianapolis, IN 46290-1076
Phone 317-574-1677 · Fax 317-574-1688
Mailing address
10291 N Meridian StSuite 300
Indianapolis, IN 46290-1076
Phone 317-574-1677 · Fax 317-574-1688
Authorized official
Arthur J Sumrall
Owner
3175741677
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