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NPI Code Detail

MEDICARE: AMBER M GATH PA

MEDICARE:   AMBER M GATH  PA
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
1363AM0700XMedical Physician Assistant10000718AIN

General Provider Information

NPI Number : 1588619035
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER M GATH PA
Provider Business Mailing Address
First Line : 1100 SOUTHFIELD DR STE 1370
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-4300
Country : US
Telephone Number : 317-837-5570
Fax Number : 317-837-5580
Provider Business Practice Location Address
First Line : 6911 E US HIGHWAY 36
Second Line :
City : AVON
State : IN
Zip : 46123-8926
Country : US
Telephone Number : 317-272-8033
Fax Number : 317-272-8044
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2006
Last Update Date : 03/17/2021

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Directions to “ AMBER M GATH PA” Practice Location

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