Individual
ERIC CHARLES SMUCLOVISKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2140 N CAPITOL AVE, INDIANAPOLIS, IN 46202-1225
(317) 349-7909
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01085491A
IN
2085R0204X
Vascular & Interventional Radiology Physician
Primary
01085491A
IN
208D00000X
General Practice Physician
R0792
TX
Other
Enumeration date
05/26/2015
Last updated
06/13/2024
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