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General NPI Number Information
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NPI Number | 1962421172
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Entity Type | Organization
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Legal Business Name | INDIANA ULTRASOUND DIAGNOSTICS
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 205 E CARMEL DR
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City | CARMEL
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State | IN
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Zip | 46032-2606
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Country | US
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Telephone | 317-569-7178
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Fax |
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Provider Business Mailing Address
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Address Line | 205 E CARMEL DR
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City | CARMEL
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State | IN
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Zip | 46032-2606
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Country | US
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Telephone | 317-569-7178
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK M GUEST
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Credential |
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Telephone | 317-569-7178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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