Individual
GANG LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, INDIANAPOLIS, IN 46202-1239
(317) 274-0275
(317) 274-0256
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
D0053730
MD
207L00000X
Anesthesiology Physician
Primary
01090514A
IN
207L00000X
Anesthesiology Physician
D0053730
MD
207L00000X
Anesthesiology Physician
S9023
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
01090514A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
095200149
MEDICARE PTAN
IN
05
—
200468910
—
MD
05
—
537300000
—
MD
Enumeration date
09/29/2005
Last updated
09/11/2023
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