Individual
MICHAEL R NIEMEIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1801 N SENATE BLVD, SUITE 230, INDIANAPOLIS, IN 46202-1252
(317) 962-5820
(317) 962-3916
Mailing address
250 N SHADELAND AVE, STE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
01028985A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100236050
—
IN
Enumeration date
08/09/2005
Last updated
02/18/2014
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