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General NPI Number Information
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NPI Number | 1073969853
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Entity Type | Individual
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Provider Name | ALEXANDRA BERNICE KREISELMAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 07/01/2016
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Provider Practice Location Address
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Address Line | 705 RILEY HOSPITAL DR ROOM 5867
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5109
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Country | US
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Telephone | 317-948-0003
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Fax |
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Provider Business Mailing Address
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Address Line | 820 LAUREL ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46203-1209
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Country | US
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Telephone | 614-565-3338
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11018982A
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License Number State | IN
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