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Physicians Allergy & Immunology

Provider NPI: 1174732804

Provider Information:
Gender: M
Not Sole Proprietor

Practice Location:
11501 CUMBERLAND RD STE 500  FISHERS, IN 46037-7010 US
Tel: 317-863-9300  Fax: 317-863-9333

Business Mailing Address:
PO BOX 603725  CHARLOTTE, NC 28260-3725 US
Tel: 828-575-2625  Fax: 828-350-2174

NPI Information:
NPI: 1174732804
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Allergy & Immunology

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 207K00000X





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