Individual
EMILY N HRISOMALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1650 W OAK ST STE 107, ZIONSVILLE, IN 46077-3835
(317) 721-4190
Mailing address
1650 W OAK ST STE 107, ZIONSVILLE, IN 46077-3835
(317) 721-4190
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01079923A
IN
207Y00000X
Otolaryngology Physician
132004
FL
207Y00000X
Otolaryngology Physician
ME132004
FL
207YS0123X
Facial Plastic Surgery Physician
01079923A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01079923A
STATE LICENSE
IN
Enumeration date
04/23/2012
Last updated
12/10/2021
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