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General NPI Number Information
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NPI Number | 1942374517
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Entity Type | Organization
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Legal Business Name | AMERIPATH INDIANAPOLIS PC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 2560 N SHADELAND AVE SUITE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-1706
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Country | US
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Telephone | 317-275-8000
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Fax | 317-275-8124
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Provider Business Mailing Address
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Address Line | 14275 MIDWAY RD SUITE 400
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City | ADDISON
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State | TX
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Zip | 75001-3614
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Country | US
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Telephone | 214-932-8018
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Fax | 610-271-4245
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Authorized Official
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Title or Position | AO
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Name | ROBERT QUIREY
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Credential | MD
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Telephone | 800-890-6220
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 15D1052105
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License Number State | IN
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