Organization
MEDIC AZ QUALITY
Active
Organization
MEDIC AZ QUALITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAMAL RAMADAN ELSAYED DSC (MANAGER)
(317) 410-2858
Entity
Organization
Contact information
Practice address
11330 KNIGHTSBRIDGE LN, FISHERS, IN 46037-9151
(317) 410-2868
(317) 578-3638
Mailing address
11330 KNIGHTSBRIDGE LN, FISHERS, IN 46037-9151
(317) 410-2868
(317) 578-3638
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
05004402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-3807519
TAX ID
IN
Enumeration date
10/18/2009
Last updated
10/18/2009
Update your record
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