Individual
DR. JONATHAN WILLIAM BUSALD PIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD RM AG012, INDIANAPOLIS, IN 46202-1239
(317) 962-3525
Mailing address
1402 STURM AVE, INDIANAPOLIS, IN 46201-3033
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01083392A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11019431A
IN
Other
Enumeration date
06/14/2017
Last updated
01/25/2020
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