Doctor Name: | INGRID MASON |
NPI Number: | 1457319915 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | IN01031079 |
Business Practice Address: | 1020 E 86th St Suite 24a Indianapolis, IN - 462401867 |
Business Phone Number: | 3175870815 |
Business Fax Number: | 3175747994 |
Mailing Address: | 1020 E 86th St, Suite 24a INDIANAPOLIS |
State: | IN |
Postal Code: | 462401867 |
Phone Number: | 3175870815 |
Fax Number: | 3175747994 |
NPI Enumeration Date: | 05/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | IN01031079 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |