Organization
WILSHIRE MEDICAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARY SOPER MD (PRESIDENT)
(317) 329-7022
Entity
Organization
Contact information
Practice address
6820 PARKDALE PL, STE 212, INDIANAPOLIS, IN 46254-6601
(317) 329-7022
(317) 329-7031
Mailing address
6820 PARKDALE PL, STE 212, INDIANAPOLIS, IN 46254-6601
(317) 329-7022
(317) 329-7031
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100078880A
—
IN
Enumeration date
03/07/2008
Last updated
03/07/2008
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