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General NPI Number Information
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NPI Number | 1043552102
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Entity Type | Organization
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Legal Business Name | INDIANA NEUROSCIENCE ASSOCIATES
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Dates
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Enumeration Date | 03/26/2013
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 8333 NAAB RD STE 260
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-5924
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Country | US
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Telephone | 317-570-7900
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Fax | 317-570-2288
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Provider Business Mailing Address
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Address Line | 6330 CASTLEPLACE DR STE 130
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-1902
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Country | US
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Telephone | 317-570-7900
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Fax | 317-570-2288
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | MR. MICHAEL H LEVINE
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Credential | MD
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Telephone | 317-570-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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