Individual
GERALD WILLIAM GODFREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8111 S EMERSON AVE, INDIANAPOLIS, IN 46237-8601
(131) 752-8814
Mailing address
PO BOX 7112, INDIANAPOLIS, IN 46207-7112
(317) 528-8148
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01047239A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200208440
—
IN
Enumeration date
01/25/2006
Last updated
04/01/2021
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