Individual
WILLIAM GARRY BIRCH IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-2345
Mailing address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
28210202A
IN
363L00000X
Nurse Practitioner
Primary
71009617A
IN
Other
Enumeration date
07/26/2019
Last updated
05/25/2022
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