Organization
SOUTHSIDE INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA R SLATER (OFFICE MANAGER)
(317) 881-0677
Entity
Organization
Contact information
Practice address
8778 MADISON AVE, STE 100, INDIANAPOLIS, IN 46227-7204
(317) 881-0677
(317) 881-0690
Mailing address
8778 MADISON AVE, STE 100, INDIANAPOLIS, IN 46227-7204
(317) 881-0677
(317) 881-0690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/05/2007
Last updated
10/15/2007
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