Organization
INTEGRATED MEDICAL CARE AND NEPHROLOGY LLC
Active
Other names
IMCN
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYANT KING MD (OWNER)
(317) 757-9731
Entity
Organization
Contact information
Practice address
6925 SHORE TER, INDIANAPOLIS, IN 46254-4675
(317) 290-8288
(317) 290-8801
Mailing address
6925 SHORE TER, INDIANAPOLIS, IN 46254-4675
(317) 290-8288
(317) 290-8801
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
01061402A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679916001
NPI
IN
Enumeration date
04/16/2013
Last updated
11/06/2013
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