Individual
JASON ANDREW COSGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
702 BARNHILL DR, INDIANAPOLIS, IN 46202-5128
(317) 312-0108
Mailing address
4109 SHADOW POINTE LN, INDIANAPOLIS, IN 46254-3755
(317) 293-6713
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11012875A
IN
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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