Individual
BRUCE A MOLITORIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
950 W WALNUT ST, E202, INDIANAPOLIS, IN 46202-5188
(317) 274-7453
Mailing address
PO BOX 44994, INDIANAPOLIS, IN 46244-0994
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01041701
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097370
—
IN
Enumeration date
04/28/2006
Last updated
02/10/2010
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