Provider Demographics
NPI:1588114912
Name:LESLEY ADIBE M.D.,P.C.
Entity type:Organization
Organization Name:LESLEY ADIBE M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADIBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:317-374-9791
Mailing Address - Street 1:PO BOX 40234
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-0234
Mailing Address - Country:US
Mailing Address - Phone:317-374-9791
Mailing Address - Fax:317-824-1161
Practice Address - Street 1:30 N EMERSON AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-8895
Practice Address - Country:US
Practice Address - Phone:317-881-3937
Practice Address - Fax:317-824-1161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-10
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01055301A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty