MEDICARE: FISHERS FAMILY PHYSICIANS

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1891763967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FISHERS FAMILY PHYSICIANS

Provider Business Mailing Address
First Line	:	11845 ALLISONVILLE RD
Second Line	:	SUITE 400
City	:	FISHERS
State	:	IN
Zip	:	46038-2313
Country	:	US
Telephone Number	:	317-842-2727
Fax Number	:	317-841-4046

Provider Business Practice Location Address
First Line	:	11845 ALLISONVILLE RD
Second Line	:	SUITE 400
City	:	FISHERS
State	:	IN
Zip	:	46038-2313
Country	:	US
Telephone Number	:	317-842-2727
Fax Number	:	317-841-4046

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	CINDY AMBS
Credential	:
Telephone Number	:	317-841-4036

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	08/22/2020

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