Healthcare Provider Details

I. General information

NPI: 1679576789
Provider Name (Legal Business Name): CHRIS L LOMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2451 INTELLIPLEX DR STE 260
SHELBYVILLE IN
46176-8580
US

IV. Provider business mailing address

30 W RAMPART ST STE 200
SHELBYVILLE IN
46176-8846
US

V. Phone/Fax

Practice location:
  • Phone: 317-398-0121
  • Fax: 317-398-0538
Mailing address:
  • Phone: 317-398-0121
  • Fax: 317-398-0538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01035445A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01035445A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: