Individual
DR. NICHOLAS FRANK HRISOMALOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10300 N ILLINOIS ST, SUITE1070, INDIANAPOLIS, IN 46290-1167
(317) 817-1500
(317) 817-1511
Mailing address
10300 N ILLINOIS ST, SUITE1070, INDIANAPOLIS, IN 46290-1167
(317) 817-1500
(317) 817-1511
Taxonomy
Speciality
Code
Description
License number
State
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
01032013B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100228280
—
IN
01
—
IN1940
MEDICARE ID
IN
Enumeration date
10/24/2005
Last updated
10/17/2017
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