Organization
NORTHSIDE GASTROENTEROLOGY, INC., PC
Active
Other names
Northside Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
GALINTON BRYAN (PRACTICE ADMIN)
(317) 872-7396
Entity
Organization
Contact information
Practice address
8424 NAAB RD, SUITE 3-J, INDIANAPOLIS, IN 46260
(317) 872-7396
(317) 879-8328
Mailing address
8424 NAAB RD, SUITE 3-J, INDIANAPOLIS, IN 46260-5918
(317) 872-7396
(317) 879-8328
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100177420
—
IN
Enumeration date
08/23/2006
Last updated
02/08/2019
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