Healthcare Provider Details

I. General information

NPI: 1508971847
Provider Name (Legal Business Name): IUMG CORPORATE HEALTH & WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 02/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 UNIVERSITY BLVD
INDIANAPOLIS IN
46202-5137
US

IV. Provider business mailing address

250 N SHADELAND AVE STE 130
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-274-4402
  • Fax: 317-274-5168
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH STOMBAUGH
Title or Position: VICE CHAIR OF FINANCE
Credential:
Phone: 317-274-1438