Organization
DERMATOLOGY CENTER OF INDIANA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT THOMAS GUENTHNER M.D. (PRESIDENT)
(317) 838-9911
Entity
Organization
Contact information
Practice address
1100 SOUTHFIELD DR STE 1240, PLAINFIELD, IN 46168-4499
(317) 838-9911
(317) 837-6080
Mailing address
111 NEW HAMPSHIRE AVE STE 2, PORTSMOUTH, NH 03801-2864
(802) 909-2053
(330) 965-9325
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
01051020A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070017306
RAILROAD MEDICARE
IN
05
—
200417550A
—
IN
01
—
7430356
AETNA
IN
Enumeration date
01/17/2006
Last updated
06/06/2023
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