Individual
GEORGE KLINE BRODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3900 ST FRANCIS WAY STE 205, LAFAYETTE, IN 47905-4939
(765) 428-2500
Mailing address
10330 N MERIDIAN ST #300, INDIANAPOLIS, IN 46290-1024
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01038029A
IN
207RC0000X
Cardiovascular Disease Physician
40119
TN
207RI0011X
Interventional Cardiology Physician
Primary
01038029A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100262360
—
IN
Enumeration date
10/24/2005
Last updated
05/17/2017
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