Organization
INDIANA HEART HOSPITAL LLC
Active
Other names
Community Pedicatric Orthopedics and Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS A MALSTO (CEO)
31776218000
Entity
Organization
Contact information
Practice address
14540 PRAIRIE LAKES BLVD NORTH, SUITE 105, NOBLESVILLE, IN 46060-4370
(317) 621-0370
(317) 621-0381
Mailing address
6435 CASTLETON WEST DRIVE, SUITE 200, INDIANAPOLIS, IN 46250-1940
(317) 621-0919
(317) 355-9760
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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