Organization
TIMOTHY M EISENHUT MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY M EISENHUT MD (MD)
(317) 291-5190
Entity
Organization
Contact information
Practice address
6640 PARKDALE PL, SUITE U, INDIANAPOLIS, IN 46254-5619
(317) 291-5190
(317) 291-1510
Mailing address
6640 PARKDALE PL, SUITE U, INDIANAPOLIS, IN 46254-5619
(317) 291-5190
(317) 291-1510
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01033758A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100228800
—
IN
Enumeration date
02/24/2012
Last updated
02/24/2012
Update your record
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