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Individual

TIMOTHY J STORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11725 N ILLINOIS ST STE 550, CARMEL, IN 46032-3009
(317) 814-4111
Mailing address
8840 COMMERCE PARK PL STE E, INDIANAPOLIS, IN 46268-3129

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01028696A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100072580
IN
Enumeration date
04/25/2006
Last updated
02/10/2015
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