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General NPI Number Information
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NPI Number | 1023457967
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Entity Type | Individual
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Provider Name | SANDRA QUICK M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 355 W 16TH ST STE 4100
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City | INDIANAPOLIS
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State | IN
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Zip | 46202
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Country | US
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Telephone | 317-963-7171
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Fax | 317-963-7346
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Provider Business Mailing Address
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Address Line | 355 W 16TH ST STE 4100
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-2394
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Country | US
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Telephone | 317-963-7171
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Fax | 317-963-7346
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 125-062954
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 11020196A
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License Number State | IN
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