Individual
TAYLOR GRANT HERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
720 ESKENAZI AVE, FIFTH THIRD BANK BUILDING THIRD FLOOR, INDIANAPOLIS, IN 46202
(317) 880-3900
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01086965A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2019
Last updated
06/09/2022
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