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General NPI Number Information
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NPI Number | 1033168836
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Entity Type | Organization
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Legal Business Name | INDIANA CENTER FOR BARIATRIC MEDICINE
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 11495 N PENNSYLVANIA ST SUITE #100
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City | CARMEL
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State | IN
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Zip | 46032-6943
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Country | US
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Telephone | 317-705-1400
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Fax |
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Provider Business Mailing Address
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Address Line | 11495 N PENNSYLVANIA ST SUITE #100
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City | CARMEL
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State | IN
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Zip | 46032-6943
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Country | US
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Telephone | 317-705-1400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EVE L OLSON
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Credential | MD
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Telephone | 317-705-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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