Healthcare Provider Details
I. General information
NPI: 1144693516
Provider Name (Legal Business Name): DAVID A PURGER MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/07/2015
Last Update Date: 09/25/2024
Certification Date: 09/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1701 N SENATE BLVD
INDIANAPOLIS IN
46202-1239
US
IV. Provider business mailing address
355 W 16TH ST STE 5100
INDIANAPOLIS IN
46202-2274
US
V. Phone/Fax
- Phone: 317-963-1300
- Fax: 317-222-2012
- Phone: 317-963-1300
- Fax: 317-222-2012
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207T00000X |
| Taxonomy | Neurological Surgery Physician |
| License Number | 01093002A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: