Provider Demographics
NPI:1124277892
Name:INDIANA UNIVERSITY SCHOOL OF MEDICINE
Entity type:Organization
Organization Name:INDIANA UNIVERSITY SCHOOL OF MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEPHROLOGY FELLOWSHIP COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-274-7453
Mailing Address - Street 1:950 W WALNUT ST
Mailing Address - Street 2:DIVISION OF NEPHROLOGY
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-5188
Mailing Address - Country:US
Mailing Address - Phone:317-274-7453
Mailing Address - Fax:317-274-8575
Practice Address - Street 1:950 W WALNUT ST
Practice Address - Street 2:DIVISION OF NEPHROLOGY, R2 BUILDING ROOM 202
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5188
Practice Address - Country:US
Practice Address - Phone:317-274-7453
Practice Address - Fax:317-274-8575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital