Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 01037809A | IN |
N | 208000000X | Pediatrician | 01037809A | IN |
NPI | 1154431567 |
---|---|
Provider Name | Bryan E Hainline |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5181 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100131040 | (05) | IN |
E24670 | (02) |