Organization
INDIANA CANCER SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRIDHAR BOLLA MD (PRESIDENT)
(317) 228-3393
Entity
Organization
Contact information
Practice address
8301 HARCOURT RD, SUITE 205, INDIANAPOLIS, IN 46260-2081
(317) 228-3393
(317) 876-1305
Mailing address
8301 HARCOURT RD, SUITE 205, INDIANAPOLIS, IN 46260-2081
(317) 228-3393
(317) 876-1305
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
02/28/2017
Last updated
02/28/2017
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