Organization
EMERGENCY MEDICINE PROFESSIONALS OF INDIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E MANSHIP MD (PRESIDENT)
(317) 870-0480
Entity
Organization
Contact information
Practice address
4011 SO MONROE MEDICAL PARK BLVD, BLOOMINGTON, IN 47403-9765
(812) 824-5700
(812) 825-0766
Mailing address
PO BOX 1204, INDIANAPOLIS, IN 46206-1204
(317) 802-3160
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200828620A
—
IN
Enumeration date
07/03/2006
Last updated
06/13/2011
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