Individual
DR. HOLLY A GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1701 N SENATE BLVD, ER DEPT, INDIANAPOLIS, IN 46202-1239
(317) 962-8880
(317) 962-7086
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01056402
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200474350
—
IN
Enumeration date
06/14/2006
Last updated
11/03/2020
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