Organization
INDIANA NEUROMONITORING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO BRKARIC MD (MEMBER)
(800) 301-7334
Entity
Organization
Contact information
Practice address
7310 GREENVIEW DR, BATTLE GROUND, IN 47920-9729
(800) 301-7334
Mailing address
DEPT # 880303 PO BOX 29650, PHOENIX, AZ 85038-9650
(800) 301-7334
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01061882A
IN MEDICAL LIC
IN
Enumeration date
03/22/2019
Last updated
05/21/2019
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