Organization
PROFESSIONAL ASSOCIATES PC
Active
Organization
PROFESSIONAL ASSOCIATES PC
Active
Other names
MEMORIAL CLINIC OF INDIANAPOLIS
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA A GOLDBERG (EXECUTIVE DIRECTOR)
(317) 924-8297
Entity
Organization
Contact information
Practice address
3266 N MERIDIAN ST, SUITE 900, INDIANAPOLIS, IN 46208-5846
(317) 924-8297
(317) 924-8348
Mailing address
3266 N MERIDIAN ST, SUITE 900, INDIANAPOLIS, IN 46208-5846
(317) 924-8297
(317) 924-8270
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
IN
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100047780
—
IN
01
—
C10473
RAIL ROAD MEDICARE GROUP
IN
Enumeration date
07/09/2006
Last updated
08/25/2010
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