MEDICARE: MR. MITCHELL PFISTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1194534172
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MITCHELL PFISTER

Provider Business Mailing Address
First Line	:	801 SHELBY ST STE 212
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-1163
Country	:	US
Telephone Number	:	888-721-3003
Fax Number	:

Provider Business Practice Location Address
First Line	:	801 SHELBY ST STE 212
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46203-1163
Country	:	US
Telephone Number	:	888-721-3003
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2025
Last Update Date	:	01/03/2025

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Directions to “ MR. MITCHELL PFISTER ” Practice Location

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