Individual
MR. CARL FREDERICK TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
3549 BOULEVARD PL, INDIANAPOLIS, IN 46208-4403
(317) 925-1300
Mailing address
3549 BOULEVARD PL, INDIANAPOLIS, IN 46208-4403
(317) 920-1300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000107A
IN
Other
Enumeration date
01/25/2008
Last updated
01/25/2008
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