Healthcare Provider Details

I. General information

NPI: 1407169030
Provider Name (Legal Business Name): GEIST CENTER FOR ALLERGY, ASTHMA & IMMUNOLOGY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2010
Last Update Date: 07/25/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8150 OAKLANDON RD
INDIANAPOLIS IN
46236-9525
US

IV. Provider business mailing address

8150 OAKLANDON RD
INDIANAPOLIS IN
46236-9525
US

V. Phone/Fax

Practice location:
  • Phone: 317-826-5440
  • Fax: 317-826-5463
Mailing address:
  • Phone: 317-826-5440
  • Fax: 317-826-5463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA LUISA PILAR D. ERMITANO
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 317-829-5440