Healthcare Provider Details
I. General information
NPI: 1255521274
Provider Name (Legal Business Name): NEW HOPE ORTHOPAEDICS AND SPORTS MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2007
Last Update Date: 07/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13400 N MERIDIAN ST STE 290
CARMEL IN
46032-7122
US
IV. Provider business mailing address
325 WESTFIELD RD STE A
NOBLESVILLE IN
46060-1496
US
V. Phone/Fax
- Phone: 317-815-1700
- Fax: 317-770-1727
- Phone: 317-770-1700
- Fax: 317-770-1727
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
PEGGY
B
MINDREBO
Title or Position: BUSINESS MANAGER
Credential:
Phone: 317-770-1700