Individual
CHARLES G NJINIMBAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE AVE, A3162, INDIANAPOLIS, IN 46202-5306
(317) 962-8174
(317) 962-1445
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 777-6435
(317) 777-6644
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
01039976
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510091
—
TN
05
—
200229850
—
IN
Enumeration date
09/13/2006
Last updated
02/11/2021
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