Individual
DR. PHILIP CHARLES FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1520 N SENATE AVE, INDIANAPOLIS, IN 46202-2213
(317) 962-8893
(317) 962-6722
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01021473
IN
Other
Enumeration date
04/19/2006
Last updated
01/30/2014
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