| NPI Details | |
|---|---|
| NPI | 1053561928 |
| Enumeration Date | 09/26/2008 |
| Last Updated | 09/11/2013 |
| Entity Type | Healthcare Provider |
| Active | Over 8 years ago |
| Authorized Information | |
|---|---|
| Name | INGRIDA IVETA INGRIDA |
| Position | PARTNER |
| Phone | (317) 329-7050 |
| Fax | (317) 328-6809 |
| Practice Location | |
|---|---|
| 6820 PARKDALE PL SUITE 211 INDIANAPOLIS IN, 46254-6600, US |
|
| Phone | (317) 329-7050 |
| Fax | (317) 328-6809 |
| Business Location | |
|---|---|
| 6820 PARKDALE PL SUITE 211 INDIANAPOLIS IN, 46254-6600, US |
|
| Phone | (317) 329-7050 |
| Fax | (317) 328-6809 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207N00000X |
| License State | Indiana |
| License Number | 01027554 |
| Remove 1053561928 NPI Number | |
According to our database, Eagle Creek Dermatology NPI is 1053561928, taxonomy code is 207N00000X and license number is 01027554, license state is located at Indiana. Eagle Creek Dermatology physically located at 6820 Parkdale Pl, Indianapolis IN, 46254-6600. NPI Number 1033115704 has the healthcare provider type.
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1053561928 NPI number is provided on an as is basis without warranty of any kind. 1053561928 is maintained by the National Plan & Provider Enumeration System. The contents of Eagle Creek Dermatology are for informational purposes only.
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