# WILSHIRE MEDICAL P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164692968
- **Authorized official:** DR. MARY SOPER MD (PRESIDENT)
- **Authorized official phone:** (317) 329-7022

## Contact information

- **Practice address:** 6820 PARKDALE PL, STE 212, INDIANAPOLIS, IN 46254-6601
- **Practice address phone:** (317) 329-7022
- **Practice address fax:** (317) 329-7031
- **Mailing address:** 6820 PARKDALE PL, STE 212, INDIANAPOLIS, IN 46254-6601
- **Mailing address phone:** (317) 329-7022
- **Mailing address fax:** (317) 329-7031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/07/2008
- **Last updated:** 03/07/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100078880A | — | IN |