=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619092186
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WESTVIEW INTERNAL MEDICINE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3660 GUION RD SUITE 310
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46222-1697
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-776-8947
-----------------------------------------------------
Fax | 317-773-8957
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 53772
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46253-0772
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-776-8947
-----------------------------------------------------
Fax | 317-773-8957
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRACTICE MANAGER
-----------------------------------------------------
Name | TERESA M WEBER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 317-776-8947
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------