Organization
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALYSSA DANIELLE FAJARDO MD (SURGERY RESIDENT)
(317) 312-0265
Entity
Organization
Contact information
Practice address
545 BARNHILL DR, EMERSON HALL 203, INDIANAPOLIS, IN 46202-5112
(317) 274-5000
Mailing address
6015 MAPLE FORGE CIR, INDIANAPOLIS, IN 46254-1266
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11012602A
IN
282N00000X
General Acute Care Hospital
11012062A
IN
Other
Enumeration date
05/30/2008
Last updated
12/22/2008
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