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General NPI Number Information
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NPI Number | 1912036104
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Entity Type | Organization
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Legal Business Name | STEVEN F ISENBERG MD INC
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 10/29/2009
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Provider Practice Location Address
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Address Line | 1400 N RITTER AVE SUITE 221
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-3052
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Country | US
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Telephone | 317-355-1010
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 N RITTER AVE SUITE 221
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-3052
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Country | US
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Telephone | 317-355-1010
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN F ISENBERG
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Credential | MD
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Telephone | 317-355-1010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 01026266
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License Number State | IN
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