Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 01025356A | IN |
NPI | 1023046588 |
---|---|
Provider Name | Alan M Golichowski |
First Address | Indianapolis, IN 46290-1024 |
Second Address | Indianapolis, IN 46260-2495 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 22/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100059980 | (05) | IN |
B28252 | (02) |