Individual
EDMUND CHARLES HASKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
9240 N MERIDIAN ST, SE 320, INDIANAPOLIS, IN 46260-1880
(317) 844-1658
Mailing address
9240 N MERIDIAN ST, STE 320, INDIANAPOLIS, IN 46260-1880
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
20040177A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100376730A
—
IN
01
—
680011626
MEDICARE RAILROAD
IN
01
—
P01157050
RR MEDICARE PTAN
IN
Enumeration date
08/19/2005
Last updated
05/21/2014
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