Individual
CHARLES BRIAN QUICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 N RITTER AVE, SUITE 375B, INDIANAPOLIS, IN 46219-3052
(317) 355-9370
(317) 355-9395
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
01029286A
IN
207RP1001X
Pulmonary Disease Physician
Primary
01029286A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100318500A
—
IN
01
—
P01210506
RR MEDICARE PTAN
IN
Enumeration date
06/13/2005
Last updated
12/05/2014
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