MEDICARE: DR. NEIL DAVID PROPST D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	02002052A	IN

General Provider Information

NPI Number	:	1578770863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL DAVID PROPST D.O.

Provider Business Mailing Address
First Line	:	10896 MUDDY RIVER RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46234-3713
Country	:	US
Telephone Number	:	317-347-0717
Fax Number	:	317-347-0717

Provider Business Practice Location Address
First Line	:	730 E WASHINGTON ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-3963
Country	:	US
Telephone Number	:	317-266-0882
Fax Number	:	317-266-0898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/08/2007

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