| NPI Details | |
|---|---|
| NPI | 1184855272 |
| Enumeration Date | 08/06/2009 |
| Last Updated | 01/14/2010 |
| Entity Type | Healthcare Provider |
| Active | Over 8 years ago |
| Authorized Information | |
|---|---|
| Name | WESLEY W WESLEY |
| Position | PRESIDENT |
| Phone | (812) 355-2300 |
| Fax | (812) 355-3251 |
| Practice Location | |
|---|---|
| 2605 E CREEKS EDGE DR BLOOMINGTON IN, 47401-8368, US |
|
| Phone | (812) 355-2300 |
| Fax | (812) 355-3251 |
| Business Location | |
|---|---|
| 550 S LANDMARK AVE BLOOMINGTON IN, 47403-3239, US |
|
| Phone | (812) 355-6900 |
| Fax | (812) 355-3251 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207QS0010X |
| License State | Indiana |
| License Number | 01066805A |
| Remove 1184855272 NPI Number | |
According to our database, Ima East Primary Care NPI is 1184855272, taxonomy code is 207QS0010X and license number is 01066805A, license state is located at Indiana. Ima East Primary Care physically located at 2605 E Creeks Edge Dr, Bloomington IN, 47401-8368. NPI Number 1033115704 has the healthcare provider type.
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1184855272 NPI number is provided on an as is basis without warranty of any kind. 1184855272 is maintained by the National Plan & Provider Enumeration System. The contents of Ima East Primary Care are for informational purposes only.
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