Organization
INFANTS IN BLOOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN MOUSER (EXECUTIVE DIRECTOR)
(812) 820-4055
Entity
Organization
Contact information
Practice address
601 WEST STREET, SUITE B, MADISON, IN 47250-3344
(812) 599-6620
Mailing address
PO BOX 795, HANOVER, IN 47243-0795
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1376577767
—
IN
05
—
1689960429
—
IN
Enumeration date
08/26/2024
Last updated
01/27/2025
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