Organization
FAMILY MEDICINE OF INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILLICENT D. MOYE M.D. (CEO)
(317) 334-1900
Entity
Organization
Contact information
Practice address
9640 N AUGUSTA DR, SUITE 413, CARMEL, IN 46032-9600
(317) 334-1900
(317) 334-1901
Mailing address
9640 N AUGUSTA DR, SUITE 413, CARMEL, IN 46032-9600
(317) 334-1900
(317) 334-1901
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01059510A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000521092
ANTHEM
IN
05
—
100143130
—
IN
Enumeration date
04/24/2007
Last updated
06/06/2008
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