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General NPI Number Information
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NPI Number | 1518258623
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Entity Type | Individual
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Provider Name | EBEN M TRUE MD
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Gender | Male
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Dates
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Enumeration Date | 04/22/2011
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Last Update Date | 03/23/2021
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Provider Practice Location Address
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Address Line | 1345 UNITY PL SUITE 235
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City | LAFAYETTE
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State | IN
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Zip | 47905-5760
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Country | US
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Telephone | 765-446-5065
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4699
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City | LAFAYETTE
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State | IN
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Zip | 47903-4699
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Country | US
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Telephone | 765-449-2732
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Fax | 765-449-1196
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 01075101A
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License Number State | IN
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