Individual
JEFFREY LASTFOGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 N MERIDIAN ST UNIT 807, INDIANAPOLIS, IN 46204-1773
(317) 374-6780
Mailing address
350 N MERIDIAN ST UNIT 807, INDIANAPOLIS, IN 46204-1773
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11016837A
IN
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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