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General NPI Number Information
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NPI Number | 1316970585
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL ASSOCIATES PC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 3266 N MERIDIAN ST SUITE 900
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-5846
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Country | US
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Telephone | 317-924-8297
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Fax | 317-924-8348
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Provider Business Mailing Address
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Address Line | 3266 N MERIDIAN ST SUITE 900
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City | INDIANAPOLIS
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State | IN
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Zip | 46208-5846
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Country | US
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Telephone | 317-924-8297
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Fax | 317-924-8270
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | REBECCA A GOLDBERG
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Credential |
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Telephone | 317-924-8297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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