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General NPI Number Information
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NPI Number | 1306046826
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC RHEUMATOLOGY AND RESEARCH PC
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Dates
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Enumeration Date | 07/23/2007
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Last Update Date | 07/23/2007
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Provider Practice Location Address
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Address Line | 1030 E COUNTY LINE RD SUITE B1
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-2932
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Country | US
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Telephone | 317-859-6364
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 E COUNTY LINE RD SUITE B1
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City | INDIANAPOLIS
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State | IN
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Zip | 46227-2932
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Country | US
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Telephone | 317-859-6364
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NANCY L GOLAY
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Credential |
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Telephone | 317-859-6364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 01026374
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License Number State | IN
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