Individual
FREIDA R THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4880 CENTURY PLAZA RD, STE 265, INDIANAPOLIS, IN 46254-5471
(317) 216-2700
(317) 216-2777
Mailing address
950 N MERIDIAN ST, STE 500 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46204-3908
(317) 962-4945
(317) 962-4950
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
01033717
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100330450
—
IN
Enumeration date
07/05/2006
Last updated
11/22/2010
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