Individual
L T GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2920 N ARLINGTON AVE, SUITE B, INDIANAPOLIS, IN 46218-3362
(317) 355-9431
(317) 355-9445
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037135A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000313170
ANTHEM
IN
05
—
100068290
—
IN
01
—
P00235875
RR MEDICARE
IN
Enumeration date
07/24/2006
Last updated
02/01/2017
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