ST. MARY ADULT MEDICINE LLC NPI 1942481965

NPI Information

ST. MARY ADULT MEDICINE, LLC is a general practice in Indianapolis, IN. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee ST. MARY ADULT MEDICINE, LLC NPI is 1942481965. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5525 GEORGETOWN RD STE F
INDIANAPOLIS, IN
ZIP 46254-717
Phone: (317) 293-9039
Fax: (317) 293-9049

The provider's authorized official is Malak G Hermina .
The authorized official title is Owner and has the following contact phone number (317) 293-9039.

The enumeration date for this NPI number is 11/19/2007 and was last updated on 9/14/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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