Provider Demographics
NPI:1104926294
Name:ALLERGY AND ASTHMA SPECIALISTS
Entity type:Organization
Organization Name:ALLERGY AND ASTHMA SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHIHFEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-872-4213
Mailing Address - Street 1:70 E 91ST ST STE 204
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-1564
Mailing Address - Country:US
Mailing Address - Phone:317-872-4213
Mailing Address - Fax:317-872-6388
Practice Address - Street 1:70 E 91ST ST STE 204
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-1564
Practice Address - Country:US
Practice Address - Phone:317-872-4213
Practice Address - Fax:317-872-6388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200329240Medicaid
IN266270Medicare PIN
INDB6081Medicare PIN