Individual
KOFI DELA QUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8051 S EMERSON AVE STE 350, INDIANAPOLIS, IN 46237-8634
(317) 859-1020
(317) 859-4040
Mailing address
6983 HILLSDALE CT, INDIANAPOLIS, IN 46250-2054
(317) 849-8350
(317) 576-6311
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
01078024A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300003131
—
IN
Enumeration date
07/10/2007
Last updated
12/04/2023
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